Ahmad Haider

Praxis Dr. Haider, Bremerhaven · Urology, Andrology

Symptomatic testosterone deficiency is common affecting 40% of men with type 2 diabetes (T2D).1 Testosterone replacement therapy (TRT) has been shown to have benefits on reducing insulin resistance, improving glycemic control and relieving symptoms of hypogonadism.2,3,4 We present early data analysis from the Association of British Clinical Diabeto...

Objective We evaluated change (Δ) in AMSS in men with adult-onset testosterone deficiency (TD) on/not on testosterone undecanoate (TU) by analysing a registry of men with adult-onset TD. Methods Analyses were performed using non-parametric statistics to determine ΔAMSS at 6–12 monthly intervals in men on/not on TU and movement in AMSS. Factors pre...

Purpose: While testosterone therapy can improve the various pathologies associated with adult-onset testosterone deficiency (TD), Summary of Product Characteristics (SPC) of five testosterone preparations caution that treatment may be associated with hypertension. This paper evaluates the impact of testosterone undecanoate (TU) on blood pressure (...

Objectives We describe studies determining the association between testosterone therapy (TTh) and mortality. Materials & methods We used a registry database of 737 men with adult‐onset testosterone deficiency defined as presenting with low serum total testosterone (TT) levels ≤12.1 nmol/L and associated symptoms over a near 10‐year follow‐up. We c...

Background: Prevalence of hypogonadism is as high as 50% in men with T2DM. ADA Guidelines recommend measuring testosterone in men with T2DM. Methods: In a registry of 883 men with hypogonadism, 370 men (41.9%) have T2DM. 190 received TU 1000 mg/12 weeks (T-group) , 180 opted against treatment (CTRL) . All patients received standard diabetes care in...

Background: Prevalence of hypogonadism in men with T2DM has been reported as high as 50%. ADA Guidelines recommend measuring testosterone in men with T2DM. Methods: Of 370 men with hypogonadism and T2DM, 302 (81.6%) were obese, 62 (16.8%) overweight and 6 (1.6%) had normal weight. 190 received injections of testosterone undecanoate 1000 mg/12 weeks...

Background: Men with hypogonadism are at increased risk of MACE and mortality. Studies in men with T2DM show that testosterone therapy reduces both MACE and mortality. Methods: In a registry of 883 men with hypogonadism, 370 men (41.9%) have T2DM. 190 received TU 1000 mg/12 weeks (T-group) , 180 opted against treatment (CTRL) . All patients receive...

Background: The prevalence of nonalcoholic fatty liver disease (NAFLD) in patients with hypogonadism and T2DM is high. Most of these patients are obese. Methods: Of 370 men with hypogonadism and T2DM, 190 received testosterone undecanoate 1000 mg/12 weeks (T-group) , 180 opted against treatment (CTRL) . Means and standard deviations of absolute mea...

Background: Reduced eGFR is associated with increased risk of cardiovascular disease and mortality. Methods: Of 370 men with hypogonadism and T2DM, 190 received testosterone undecanoate 1000 mg/12 weeks (T-group) , 180 opted against treatment (CTRL) . Means and standard deviations of absolute measures over 13 years are reported. eGFR was calculated...

Background: Previous studies reported inconsistent effects of testosterone therapy on the lipid profile in men with hypogonadism. Methods: Of 370 men with hypogonadism and T2DM, 190 received testosterone undecanoate 1000 mg/12 weeks (T-group) , 180 opted against treatment (CTRL) . Means and standard deviations of absolute measures over 13 years of...

Background and objective: Findings on the association between testosterone and cardiovascular risk in men have been inconsistent. Previous studies investigated this association based on testosterone level measured at one single point in time (e.g., testosterone level at the baseline visit), which might not be relevant for the future cardiovascu...

Objectives We aimed to evaluate the association of testosterone deficiency with inflammation and how long-term testosterone therapy affects inflammation biomarkers over time. Methods We conducted a 2-component study. First, we conducted a cross-sectional study using the recently released 2015-2016 National Health and Nutrition Examination Survey (...

Langzeitbehandlung bis zu 12 Jahren mit Testosteron bei Männern mit Hypogonadismus und Adipositas verbesserte das Lipidmuster, das sich bei unbehandelten Kontrollpatienten verschlechterte. Die Verbesserungen des Lipidmusters können zur Reduktion der Mortalität beigetragen haben. Publication History Publication Date: 24 September 2021 (online) © 20...

Langzeitbehandlung mit Testosteron bei hypogonadalen Männern mit T2DM führte zu nachhaltigem Gewichtsverlust und verbesserte die glykämische Kontrolle im Vergleich zu unbehandelten Kontrollpatienten. Publication History Publication Date: 24 September 2021 (online) © 2021. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469...

Background: Men with hypogonadism are at increased risk of MACE and mortality. Studies in men with T2DM show that testosterone therapy (TTh) reduces both MACE and mortality. Methods: Of 361 men with hypogonadism and T2DM, 183 received testosterone undecanoate injections (TU) 1000 mg/12 weeks (T-group), 178 opted against treatment (CTRL). MACE, mort...

Background: Reduced eGFR is associated with increased risk of cardiovascular disease and mortality. Methods: In a registry of 865 men with hypogonadism, 361 men (41.7%) had T2DM. 183 received TU 1000 mg every 12 weeks (T-group). 178 opted against treatment (CTRL). Changes over time between groups were compared and adjusted for age, weight, waist ci...

Background: Previous studies reported inconsistent effects of testosterone therapy on the lipid profile in men with hypogonadism. Methods: Of 361 men with hypogonadism and T2DM, 183 received TU 1000 mg/12 weeks (T-group), 178 opted against treatment (CTRL). Changes over time between groups were compared and adjusted for age, weight, waist circumfer...

Background: Prevalence of hypogonadism has been reported as high as 50% in men with T2DM. ADA Guidelines recommend assessment of hypogonadism in men with T2DM. Methods: In a registry of 865 men with hypogonadism, 361 men (41.7%) had T2DM. 183 received TU 1000 mg/12 weeks (T-group), 178 opted against treatment (CTRL). Changes over time between group...

Background: The prevalence of hypogonadism is particularly high in men with obesity and T2DM. Methods: Of 361 men with hypogonadism and T2DM, 293 (81.2%) were obese, 61 (16.9%) overweight and 7 (1.9%) had normal weight. 183 received TU 1000 mg/12 weeks (T-group) following an initial 6-week interval, 178 opted against treatment (CTRL). Changes over...

Background: Low testosterone level has been associated with predictors of cardiovascular disease (CVD); however, controversies exist regarding the role of testosterone therapy, a treatment to improve testosterone lev- els, in preventing cardiovascular risk. Longitudinal studies with a large sample size and long follow-up duration are limited. Mater...

Low baseline testosterone level has been associated with the development of risk factors for cardiovascular disease such as insulin resistance and obesity. In addition to the absolute testosterone level, remarkable changes in testosterone level may have an acute effect on cardiovascular disease development and progression, which has been rarely inv...

Aims: Type 2 diabetes mellitus (T2DM) is a public health threat. Men with T2DM often exhibit hypogonadism. We investigated whether testosterone therapy (TTh) in men with hypogonadism and T2DM improves glycemic control, insulin sensitivity and results in remission of T2DM. Material and methods: 356 men who had total testosterone (T) ≤12.1 nmol/L...

Background: The prevalence of hypogonadism is particularly high in men with obesity and T2DM. Methods: Of 356 men with hypogonadism and T2DM, 288 (80.9%) were obese, 61 (17.1%) overweight and 7 (2.0%) had normal weight. 178 received TU 1000 mg/12 weeks (T-group) following an initial 6-week interval, 178 opted against treatment (CTRL). Changes over...

Background: Men with hypogonadism are at increased risk of MACE and mortality. Studies in men with T2DM show that testosterone therapy (TTh) reduces both MACE and mortality. Methods: In a registry of 858 men with hypogonadism, 356 men (41.5%) had T2DM. 178 received testosterone undecanoate injections (TU) 1000 mg/12 weeks (T-group) and 178 opted ag...

Background: Reduced eGFR is associated with increased risk of cardiovascular disease and mortality. Methods: In a urological practice registry of 858 men with hypogonadism, 356 men (41.5%) had T2DM. 178 received TU 1000 mg every 12 weeks (T-group). 178 opted against treatment (CTRL). Changes over time between groups were compared and adjusted for a...

Background: In 2018, ADA Standards of Medical Care in Diabetes added measurement of testosterone levels in men with T2DM as new recommendation. Methods: A registry of men with hypogonadism (testosterone ≤12.1 nmol/L) was initiated in 2004 in a urological practice setting. 356 of 858 patients (41.5%) had T2DM diagnosed and treated in a diabetes cent...

Background: Previous studies reported inconsistent effects of testosterone therapy on the lipid profile in men with hypogonadism. Methods: Of 356 men with hypogonadism and T2DM, 178 received TU 1000 mg/12 weeks (T-group), 178 opted against treatment (CTRL). Changes over time between groups were compared and adjusted for age, weight, waist circumfer...

Background: Prevalence of hypogonadism has been reported as high as 50% in men with T2DM. ADA Guidelines recommend assessment of hypogonadism in men with T2DM. Methods: In a registry of 858 men with hypogonadism, 356 men (41.5%) had T2DM. 178 received TU 1000 mg/12 weeks (T-group), 178 opted against treatment (CTRL). Changes over time between group...

Background Although prostate cancer (PCa) screening is conducted before testosterone replacement therapy (TRT), clinically occult PCa cases may exist. Methods To evaluate whether the possible inclusion of occult PCa cases distorts the effect of TRT on risk of PCa, we followed 776 hypogonadal males (TRT = 400, non-TRT = 376) from a urology center i...

Background: Men with T2DM have a high prevalence of hypogonadism. Methods: In a registry of 823 men with hypogonadism, 324 men (39%) had T2DM. 152 received TU 1000 mg/12 weeks (T-group), 172 opted against treatment (CTRL). Changes over time between groups were compared by mixed effects model for repeated measures with random effect for intercept an...

Background: Potential cardiovascular risk as a result of testosterone therapy is controversially discussed. Methods: In a registry of 823 men with hypogonadism, 324 men (39%) had T2DM. 152 received TU 1000 mg/12 weeks (T-group), 172 opted against treatment (CTRL). Changes over time between groups were compared by mixed effects model for repeated me...

Background: In the literature, effects of testosterone on lipid pattern in men with hypogonadism are inconsistent. Methods: Of 324 men with hypogonadism and T2DM in a registry, 152 received TU 1000 mg/12 weeks (T-group), 172 opted against treatment (CTRL). Mean changes over time between groups were compared by mixed effects model for repeated measu...

Background: Testosterone is inversely correlated with weight and waist circumference (WC). Methods: Of 324 men with hypogonadism and T2DM in a registry, 257 (79.3%) were obese, 60 (18.5%) overweight and 7 (2.2%) had normal weight. 152 received TU 1000 mg/12 weeks (T-group), 172 opted against treatment (CTRL). Changes over time between groups were c...

Background: In the 2018 ADA Standards of Medical Care in Diabetes checking testosterone in men with diabetes was added as new recommendation. Methods: A registry of hypogonadal men (testosterone ≤12.1 nmol/L) was initiated in 2004 in a urological setting. By 2018, 324 of 823 patients (39%) had T2DM diagnosed and treated in a diabetes center. 152 of...

Background: Weight loss in obese subjects is notoriously difficult to achieve through lifestyle interventions, and even harder to maintain long-term. Testosterone therapy has shown promising results in long-term but not short-term studies. Material and Methods: In an observational registry study of 805 men with hypogonadism in a urological office,...

Background: The prevalence of hypogonadism in men with hypertension is high and may be related to overweight and obesity. In an ongoing registry study in a single urology practice, we monitored blood pressure and hemodynamic parameters for up to 12 years. Material and Methods: In a registry study of men with hypogonadism in a urological office, 676...

Background: Quality of life in men is influenced by general health, sexual function and urinary function. These components are associated with both weight and inflammatory status. Material and Methods: 805 men with hypogonadism are enrolled in a registry study in a urological office. 412 received TTh with TU 1000 mg/12 weeks (T-group) while 393 opt...

Background: Testosterone and its metabolite estradiol are essential factors in bone metabolism, and hypogonadism is an established risk factor for osteoporosis. Material and Methods: In a registry study of otherwise unselected men with hypogonadism in a urological office, 102 of 805 patients (13%) had osteoporosis diagnosed and treated elsewhere. 6...

Background: Effects of testosterone on lipid patterns are inconsistent. While in short-term studies, testosterone usually lowers HDL, long-term studies seem to increase HDL. Total cholesterol, LDL and triglycerides are either reduced by TTh, or effects are neutral. Effects of TTh on lipids may depend on treatment duration. Material and Methods: In...

Background: 3 studies reported an increased cardiovascular risk with TTh while hundreds of studies have demonstrated cardiovascular benefits of TTh in men with hypogonadism. Material and Methods: A prospective, cumulative registry study to investigate long-term effectiveness and safety of depot TU to treat hypogonadism was established in 2004 in a...

Objectives: To investigate whether testosterone replacement therapy (TRT) reduces prostate cancer (PCa) risk via stabilizing serum testosterone (T) levels beyond simply elevating serum T levels and whether TRT reduces PCa risk due to low serum T levels at a young age. Methods: We analyzed data of 776 hypogonadal men from a urology center in Bremerh...

Objective: Type 2 diabetes (T2D) is a public health threat. Prediabetes represents a window of opportunity for intervention to prevent T2D. Men with T2D and prediabetes often have low testosterone. Since testosterone improves glycemic control in T2D, we investigated whether testosterone therapy (TTh) in men with hypogonadism and prediabetes preven...

304 Background: Guidelines by AUA and EAU state that there is no evidence for an increased PCa risk for testosterone (T) treatment in hypogonadal men. Methods: In a registry study initiated in 2004 in a urology practice, 428 hypogonadal men (T≤350 ng/dL) received T undecanoate 1000 mg every 3 months following an initial 6-month interval for up to 1...

Objective: The association between erectile dysfunction (ED), hypogonadism, cardiovascular disease, and type 2 diabetes is well documented, but long-term data are limited. The aim of this study is to investigate effects of long-term testosterone therapy (TTh) with testosterone undecanoate in men with hypogonadism and ED. Patients and methods: Obser...

For obese type 2 diabetes patients, weight reduction is one of the most important measures but fails in most cases. Testosterone deficiency can be the reason for such failure. This case presents a 57-year-old man who was referred to a urologist due to benign prostatic hyperplasia and erectile dysfunction. He had type 2 diabetes, was overweight, and...

Purpose To analyze data from an observational, prospective, cumulative registry study in 805 hypogonadal men stratified by mild or moderate-to-severe lower urinary tract symptoms (LUTS) according to International Prostate Symptom Score. Materials and Methods A total of 412 men underwent testosterone therapy (TTh) with injectable testosterone undec...

(A) Total cholesterol (mmol/L) in men with mild IPSS with TTh and untreated controls, and in men with moderate-to-severe IPSS with TTh and untreated controls. (B) High density lipoprotein cholesterol (mmol/L) in men with mild IPSS with TTh and untreated controls, and in men with moderate-to-severe IPSS with TTh and untreated controls. (C) Low densi...

(A) Systolic blood pressure (mmHg) in men with mild IPSS with TTh and untreated controls, and in men with moderate-to-severe IPSS with TTh and untreated controls. (B) Diastolic blood pressure (mmHg) in men with mild IPSS with TTh and untreated controls, and in men with moderate-to-severe IPSS with TTh and untreated controls. IPSS, International Pro...

(A) Fasting glucose (mmol/L) in men with mild IPSS with TTh and untreated controls, and in men with moderate-to-severe IPSS with TTh and untreated controls. (B) HbA1c (%) in men with mild IPSS with TTh and untreated controls, and in men with moderate-to-severe IPSS with TTh and untreated controls. IPSS, International Prostate Symptom Score; TTh, te...

Testosterone (nmol/L) in men with mild IPSS with TTh and untreated controls, and in men with moderate-to-severe IPSS with TTh and untreated controls. IPSS, International Prostate Symptom Score; TTh, testosterone therapy.

Background: Hypogonadism is highly prevalent in men with T2DM. Methods: Of 805 hypogonadal men in a urological registry, 311 men (39%) had T2DM diagnosed and treated elsewhere. 141 received TU 1000 mg/12 weeks (T-group), 170 opted against treatment (CTRL). Mean changes over time between groups were compared by mixed effects model. Changes were adju...

Background: Hypogonadism predicts T2DM and is highly prevalent in men with prediabetes. Methods: Pooled data from 2 ongoing urological registries. 303 men had prediabetes by HbA1c according to ADA definition. 220 received treatment with 3-monthly injections of testosterone undecanoate (TU; T-group), 83 served as controls (CTRL). Anthropometric and...

Background: Hypogonadism is highly prevalent in men with obesity as well as T2DM. Methods: Of 805 hypogonadal men in a urological registry, 311 men (39%) had T2DM diagnosed and treated elsewhere. 141 received TU 1000 mg/12 weeks (T-group), 170 opted against treatment (CTRL). Mean changes over time between groups were compared by mixed effects model...

Background: According to 2016 AACE/ACE obesity guidelines, hypogonadism should be assessed and treated in indicated in men with type 2 diabetes mellitus (T2DM). Methods: In a registry of hypogonadal men (testosterone ≤12.1 nmol/L) conducted since 2004 in a urological setting, 133/400 patients (33.3%) had T2DM diagnosed and treated in a diabetes cen...

167 Background: There is no evidence that TTh in hypogonadal men increases PCa incidence or severity. A US-Scandinavian group recently found that men receiving TTh had lower risk of aggressive PCa (Loeb S et al., J Clin Oncol 2017; 35:1430-6). Methods: 412 men with testosterone ≤350 ng/dL and symptoms received testosterone undecanoate 1000 mg every...

Purpose: We proposed to investigate whether dynamic patterns of testosterone (T) levels contribute to risk of prostate cancer (PCa). Materials and methods: We used data from 376 untreated hypogonadal men (T ≤ 12.1 nmol/L) recruited from a urology office in Germany. Study entry age was used as a surrogate for age at first detecting T below 12.1 n...

In daily practice, clinicians are often confronted with obese type 2 diabetes mellitus (T2DM) patients for whom the treatment plan fails and who show an inadequate glycemic control and/or no sustainable weight loss. Untreated hypogonadism can be the reason for such treatment failure. This case describes the profound impact testosterone therapy can...

Objectives: In the absence of large, prospective, placebo-controlled studies of longer duration, substantial evidence regarding the safety and risk of testosterone (T) therapy (TTh) with regard to cardiovascular (CV) outcomes can only be gleaned from observational studies. To date, there are limited studies comparing the effects of long-term TTh i...

Objectives: To investigate the effects of long-term testosterone (T) therapy (TTh) on urinary and sexual functions and quality of life (QoL) in hypogonadal men. Patients and methods: Observational, prospective, cumulative registry study in 656 men (age: 60.7 ± 7.2 years) with total T levels ≤12.1 nmol/L and symptoms of hypogonadism. In the T-tre...

Background Dutasteride has been successfully used in treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). However, dutasteride inhibits 5α-reductase type 1 and type 2 enzymes and may compromises glucocorticoids and androgen metabolism and alters metabolic function resulting in undesirable metabolic and s...

5085 Background: There is no evidence that TTh in men with hypogonadism increases PCa incidence or severity. A Canadian group recently found that long-term TTh decreased the risk of PCa diagnosis (Wallis et al., Lancet Diab Endocrinol 2016; 4:498). We assessed incidence and severity of PCa in hypogonadal men on long-term TTh (T-group) in comparison...

33Background: Despite persisting concerns, there is no evidence that TTh in men with hypogonadism increases PCa incidence or severity. Rather, a Canadian group recently found that long-term TTh decreased the risk of PCa diagnosis (Wallis et al., Lancet Diab Endocrinol 2016; 4:498). We assessed incidence and severity of PCa in hypogonadal men on lon...

Background/objectives Long-term testosterone therapy (TTh) in men with hypogonadism has been shown to improve all components of the metabolic syndrome. In this study, we investigated the effects of long-term TTh up to 8 years in hypogonadal men with a history of cardiovascular disease (CVD). Patients and methods In two urological clinics observati...