Androgen replacement in men with hypogonadism and erectile dysfunction.
ABSTRACT The prevalence of hypogonadism and erectile dysfunction (ED) increases with age. Hypogonadism also is frequently associated with decreased libido and ED. Testosterone replacement therapy for hypogonadal ED is effective in restoring sexual desire and erectile function, especially in younger and healthy men. It appears to be less effective in older men with comorbid diseases that may cause ED. Therapy should be individualized, considered carefully, and closely monitored because of potential risks, especially in older men. The FDA has approved several testosterone delivery systems. These include a buccal testosterone tablet, intra-muscular injections, transdermal and subcutaneous forms. There also are several promising experimental androgens under investigation including non-steroidal selective androgen receptor modulators (SARMs).
- [Show abstract] [Hide abstract]
ABSTRACT: Reference intervals were calculated for male testosterone, SHBG, FSH and LH in serum from 599 individuals in the NORIP study. At 30 years of age, reference limits were calculated to 10.4-32.6 nmol/L testosterone, 13.5-57.4 nmol/L SHBG, 1.93-9.7 IU/L LH and 1.5-10.3 IU/L FSH, at 50 years, 9.3-31.3 nmol/L (testosterone), 18.4-75.6 nmol/L (SHBG), 2.01-10.4 IU/L (LH) and 2.04-12.4 IU/L (FSH), and at 70 years 8.6 to 30.7 nmol/L (testosterone), 27.8-101 nmol/L (SHBG), 2.22-11.2 IU/L (LH) and 2.71-14.2 IU/L (FSH). All age-+related changes were statistically significant. Reference intervals were also calculated for indices derived from testosterone, SHBG and albumin. Free androgen index, simply the ratio between testosterone and SHBG, returned results differing from the other elaborate indices, and the study thus favors use of a more elaborate index such as calculated free testosterone (CFT).Scandinavian journal of clinical and laboratory investigation 11/2009; 69(8):873-9.e1-11. · 1.38 Impact Factor
- 02/2014: pages 279-295; , ISBN: 978-953-51-1215-0
- [Show abstract] [Hide abstract]
ABSTRACT: Hypogonadism is associated with impaired libido and erectile dysfunction in young men, but the causes of sexual dysfunction in older men are less well understood. To determine the prevalence and predictors of sexual problems in older men. Sexual problems, as assessed by a self-reported questionnaire. This was a population-based, cohort study of 3,274 community-dwelling men aged 75-95 years (mean 82 years) from Perth, Western Australia. Questionnaires in 2001-2004 and 2008-2009 assessed social and medical risk factors. Sex hormones were measured in 2001-2004. Predictors of sexual problems, measured in 2008-2009, were assessed cross-sectionally in the entire sample, and longitudinally in a subset of 1,744 men with sex hormone data. Sexual problems were highly prevalent, with 49.4% (95% confidence interval 47.7% to 51.1%) reporting erectile problems, 47.7% (45.9% to 49.4%) lacking interest in sexual activity, 38.7% (37.0% to 40.3%) unable to climax, and 20.4% (19.1% to 21.8%) anxious about their ability to perform sexually. Painful and unpleasurable sex were less common (<5%). Overall, 72.0% (70.5% to 73.6%) reported at least one problem. In multivariate binary logistic regression analyses, cardiovascular disease, diabetes, depression, prostate disorders, and insomnia were the factors most commonly associated with sexual problems. Low testosterone levels were associated with lack of interest in sex, but not with other complaints. Sexual problems are common in elderly men. Chronic disease, depression, and insomnia appear to be the main modifiable risk factors. Androgen deficiency is unlikely to be a major cause of sexual problems in this age group.Journal of Sexual Medicine 12/2011; 9(2):442-53. · 3.51 Impact Factor