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3.
Eur J Endocrinol ; 182(6): 539-548, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32213659

RESUMO

Background: Hypogonadism is prevalent during opioid treatment, but the effect of testosterone replacement treatment (TRT) on body composition, pain perception, and adrenal function is unclear. Purpose: To measure changes in body composition, pain perception, quality of life, and adrenal function after TRT or placebo in opioid-treated men with chronic non-malignant pain. Methods: Double-blind, placebo-controlled study in 41 men (>18 years) with total testosterone <12 nmol/L were randomized to 24 weeks TRT (Testosterone undecanoate injection three times/6 months, n = 20) or placebo (placebo-injections, n = 21). Outcomes: Body composition (lean body mass and fat mass assessed by DXA), clinical pain intensity (numerical rating scale), and experimental pain perception (quantitative sensory assessment), quality of life (SF36), and adrenocorticotrophic hormone (ACTH) test. Data were presented as median (quartiles). Mann-Whitney tests were performed on delta values (24-0 weeks) between TRT and placebo. Results: The median age was 55 years (46; 59) and total testosterone before intervention was 6.8 (5.0; 9.3) nmol/L. TRT was associated with change of testosterone levels: 12.3 (7.0; 19.9) nmol/L (P < 0.001 vs placebo), increased lean body mass: 3.6 (2.3; 5.0) kg vs 0.1 kg (-2.1; 1.5) during TRT vs placebo and decreased total fat mass: -1.2 (-3.1; 0.7) kg vs 1.2 kg (-0.9; 2.5) kg, both P < 0.003. Changed pain perception, SF36, and ACTH-stimulated cortisol levels were non-significantly changed during TRT compared with placebo. Conclusions: Six months of TRT improved body composition in men with opioid-induced hypogonadism without significant changes in outcomes of pain perception, quality of life, or adrenal function.


Assuntos
Analgésicos Opioides/efeitos adversos , Terapia de Reposição Hormonal/métodos , Hipogonadismo/induzido quimicamente , Hipogonadismo/tratamento farmacológico , Testosterona/uso terapêutico , Idoso , Composição Corporal/efeitos dos fármacos , Método Duplo-Cego , Humanos , Hipogonadismo/psicologia , Masculino , Pessoa de Meia-Idade , Percepção da Dor/efeitos dos fármacos , Qualidade de Vida , Resultado do Tratamento
6.
Horm Res Paediatr ; 92(4): 215-228, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31851967

RESUMO

BACKGROUND: In adolescents, testosterone may have several effects including promotion of secondary sexual characteristics and pubertal growth, attainment of optimal muscle mass and peak bone mass, optimization of the metabolic profile, and psychosocial maturation and well-being. SUMMARY: Testosterone therapy is a cornerstone of the management of hypogonadism in boys. Since the initial report of the chemical synthesis of testosterone, several formulations have continued to develop, and although many of these have been used in boys, none of them have been studied in detail in this age group. Given the wide ranging effects of testosterone, the level of evidence for their effects in boys and the heterogeneity of conditions that lead to early-onset hypogonadism, a standardized protocol for monitoring testosterone replacement in this age group is needed. Key Messages: In this review, we focus on the perceived benefits of androgen replacement in boys affected by pubertal delay and highlight the need to improve the health monitoring of boys who receive androgen replacement therapy, proposing different approaches based on the underlying pathophysiology.


Assuntos
Hipogonadismo/tratamento farmacológico , Puberdade Tardia/tratamento farmacológico , Testosterona/uso terapêutico , Adolescente , Terapia de Reposição Hormonal/métodos , Humanos , Masculino
7.
Drugs Aging ; 36(11): 981-989, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31595418

RESUMO

The number of older adults over 65 years of age is expected to increase to almost 100 million in the US by 2050, more than double the current figure of 46 million. Advanced age is associated with increased frailty among older Americans and often leads to increased disability, hospitalization, institutionalization, and, eventually, mortality. In search of means to improve age-related risks for adverse health outcomes, the question of restoring diminishing sex hormones has gathered much interest and has led to the practice of sex hormone replacement therapies in older men. Recent data suggest that androgen prescription rates in the US for men older than 60 years of age quadrupled from the years 2001 to 2011. While prescription sales of testosterone have increased from $150 million in 2000 to $1.8 billion in 2011, a significant portion of men prescribed testosterone replacement therapy did not meet the laboratory criteria for hypogonadism. While some clinical trials reported an association between testosterone insufficiency in older men and increased risk of death, the exact effects and consequences of testosterone replacement therapy, specifically in older men, remain unclear. This review is aimed at discussing the possible benefits and complications of testosterone replacement therapy in older men over 60 years of age.


Assuntos
Androgênios/uso terapêutico , Terapia de Reposição Hormonal , Hipogonadismo/tratamento farmacológico , Testosterona/uso terapêutico , Idoso , Terapia de Reposição Hormonal/efeitos adversos , Terapia de Reposição Hormonal/métodos , Humanos , Hipogonadismo/metabolismo , Masculino , Pessoa de Meia-Idade , Medição de Risco , Resultado do Tratamento
8.
Medicine (Baltimore) ; 98(31): e16616, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31374027

RESUMO

BACKGROUND: To compare the efficacies of gonadotropin-releasing hormone (GnRH) pulse subcutaneous infusion with combined human chorionic gonadotropin and human menopausal gonadotropin (HCG/HMG) intramuscular injection have been performed to treat male hypogonadotropic hypogonadism (HH) spermatogenesis. METHODS: In total, 220 idiopathic/isolated HH patients were divided into the GnRH pulse therapy and HCG/HMG combined treatment groups (n = 103 and n = 117, respectively). The luteinizing hormone and follicle-stimulating hormone levels were monitored in the groups for the 1st week and monthly, as were the serum total testosterone level, testicular volume and spermatogenesis rate in monthly follow-up sessions. RESULTS: In the GnRH group and HCG/HMG group, the testosterone level and testicular volume at the 6-month follow-up session were significantly higher than were those before treatment. There were 62 patients (62/117, 52.99%) in the GnRH group and 26 patients in the HCG/HMG (26/103, 25.24%) group who produced sperm following treatment. The GnRH group (6.2 ±â€Š3.8 months) had a shorter sperm initial time than did the HCG/HMG group (10.9 ±â€Š3.5 months). The testosterone levels in the GnRH and HCG/HMG groups were 9.8 ±â€Š3.3 nmol/L and 14.8 ±â€Š8.8 nmol/L, respectively. CONCLUSION: The GnRH pulse subcutaneous infusion successfully treated male patients with HH, leading to earlier sperm production than that in the HCG/HMG-treated patients. GnRH pulse subcutaneous infusion is a preferred method.


Assuntos
Hormônio Liberador de Gonadotropina/uso terapêutico , Hipogonadismo/tratamento farmacológico , Substâncias para o Controle da Reprodução/uso terapêutico , Espermatogênese/efeitos dos fármacos , Adolescente , Adulto , Gonadotropina Coriônica/uso terapêutico , Vias de Administração de Medicamentos , Esquema de Medicação , Combinação de Medicamentos , Hormônio Foliculoestimulante/sangue , Hormônio Liberador de Gonadotropina/administração & dosagem , Humanos , Bombas de Infusão , Hormônio Luteinizante/sangue , Masculino , Menotropinas/uso terapêutico , Substâncias para o Controle da Reprodução/administração & dosagem , Testosterona/sangue , Adulto Jovem
9.
Int Braz J Urol ; 45(5): 1008-1012, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31408289

RESUMO

PURPOSE: The 2018 American Urological Association guidelines on the Evaluation and Management of Testosterone Deficiency recommended that 300 ng/dL be used as the threshold for prescribing testosterone replacement therapy (TRT). However, it is not uncommon for men to present with signs and symptoms of testosterone deficiency, despite having testosterone levels greater than 300 ng/dL. There exists scant literature regarding the use of hCG monotherapy for the treatment of hypogonadism in men not interested in fertility. We sought to evaluate serum testosterone response and duration of therapy of hCG monotherapy for men with symptoms of hypogonadism, but total testosterone levels > 300 ng/dL. MATERIALS AND METHODS: We performed a multi-institutional retrospective case series of men receiving hCG monotherapy for symptomatic hypogonadism. We evaluated patient age, treatment indication, hCG dosage, past medical history, physical exam findings and serum testosterone and gonadotropins before and after therapy. Descriptive analysis was performed and Mann Whitney U Test was utilized for statistical analysis. RESULTS: Of the 20 men included in the study, treatment indications included low libido (45%), lack of energy (50%), and erectile dysfunction (45%). Mean testosterone improved by 49.9% from a baseline of 362 ng/dL (SD 158) to 519.8 ng/dL (SD 265.6), (p=0.006). Median duration of therapy was 8 months (SD 5 months). Fifty percent of patients reported symptom improvement. CONCLUSIONS: Treatment of hypogonadal symptoms with hCG for men who have a baseline testosterone level > 300 ng/dL appears to be safe and effi cacious with no adverse events.


Assuntos
Gonadotropina Coriônica/uso terapêutico , Hipogonadismo/tratamento farmacológico , Substâncias para o Controle da Reprodução/uso terapêutico , Testosterona/sangue , Adulto , Idoso , Terapia de Reposição Hormonal/métodos , Humanos , Hipogonadismo/sangue , Masculino , Pessoa de Meia-Idade , Valores de Referência , Reprodutibilidade dos Testes , Estudos Retrospectivos , Estatísticas não Paramétricas , Resultado do Tratamento
11.
J Urol ; 202(5): 1029-1035, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31216250

RESUMO

PURPOSE: Clomiphene citrate may be used as an off label treatment of hypogonadism. There are few long-term data on clomiphene citrate efficacy and safety when administered for more than 3 years. We assessed improvements in testosterone and hypogonadal symptoms while on clomiphene citrate for extended periods. MATERIALS AND METHODS: We performed a retrospective review to identify patients treated with clomiphene citrate for hypogonadism (baseline testosterone less than 300 ng/dl) at a total of 2 institutions from 2010 to 2018. We assessed the duration of clomiphene citrate therapy, serum testosterone levels, symptom improvement and clomiphene citrate side effects. RESULTS: A total of 400 patients underwent clomiphene citrate treatment for a mean ± SD of 25.5 ± 20.48 months (range 0 to 84). Of the patients 280 received clomiphene citrate for 3 years or less (mean 12.75 ± 9.52 months) and 120 received it for more than 3 years (mean 51.93 ± 10.52 months). Of men on clomiphene citrate for more than 3 years 88% achieved eugonadism, 77% reported improved symptoms and 8% reported side effects. Estradiol was significantly increased following clomiphene citrate treatment. Results did not significantly differ between patients treated for more than 3, or 3 or fewer years. The most common side effects reported by patients treated more than 3 years included changes in mood in 5, blurred vision in 3 and breast tenderness in 2. There was no significant adverse event in any patient treated with clomiphene citrate. CONCLUSIONS: Clomiphene citrate is not typically offered as primary treatment of hypogonadism in men who do not desire fertility preservation. These data demonstrate that clomiphene citrate is safe and effective with few side effects when used as long-term treatment of hypogonadism.


Assuntos
Clomifeno/administração & dosagem , Hipogonadismo/tratamento farmacológico , Adulto , Biomarcadores/sangue , Relação Dose-Resposta a Droga , Estradiol/sangue , Seguimentos , Gonadotropinas/sangue , Humanos , Hipogonadismo/sangue , Masculino , Prolactina/sangue , Estudos Retrospectivos , Moduladores Seletivos de Receptor Estrogênico/administração & dosagem , Testosterona/sangue , Fatores de Tempo , Resultado do Tratamento
12.
Eur J Endocrinol ; 181(1): R23-R43, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31096185

RESUMO

Evidence has been accumulating that, in men, some of the biological actions traditionally attributed to testosterone acting via the androgen receptor may in fact be dependent on its aromatization to estradiol (E2). In men, E2 circulates at concentrations exceeding those of postmenopausal women, and estrogen receptors are expressed in many male reproductive and somatic tissues. Human studies contributing evidence for the role of E2 in men comprise rare case reports of men lacking aromatase or a functional estrogen receptor alpha, short-term experiments manipulating sex steroid milieu in healthy men, men with organic hypogonadism or men with prostate cancer treated with androgen deprivation therapy (ADT) and from observational studies in community-dwelling men. The collective evidence suggests that, in men, E2 is an important hormone for hypothalamic-pituitary-testicular axis regulation, reproductive function, growth hormone insulin-like growth factor-1 axis regulation, bone growth and maintenance of skeletal health, body composition and glucose metabolism and vasomotor stability. In other tissues, particularly brain, elucidation of the clinical relevance of E2 actions requires further research. From a clinical perspective, the current evidence supports the use of testosterone as the treatment of choice in male hypogonadism, rather than aromatase inhibitors (which raise testosterone and lower E2), selective androgen receptor modulators and selective estrogen receptor modulators (with insufficiently understood tissue-specific estrogenic effects). Finally, E2 treatment, either as add-back to conventional ADT or as sole mode of ADT could be a useful strategy for men with prostate cancer.


Assuntos
Estradiol/uso terapêutico , Estrogênios/uso terapêutico , Terapia de Reposição Hormonal/métodos , Hipogonadismo/tratamento farmacológico , Neoplasias da Próstata/tratamento farmacológico , Androgênios/metabolismo , Hormônios Esteroides Gonadais/metabolismo , Humanos , Masculino , Receptores Estrogênicos/metabolismo , Testosterona/uso terapêutico
13.
Acta Biomed ; 90(2): 228-232, 2019 05 23.
Artigo em Inglês | MEDLINE | ID: mdl-31125000

RESUMO

BACKGROUND: Hormonal treatment of hypogonadism in thalassaemia major (TM) is a complex issue due to the co-existence of other contributing factors such as severity of iron overload, associated chronic liver disease and other endocrine complications. OBJECTIVES: Data about adverse events (AEs) of testosterone replacement therapy (TRT) in hypogonadal males with TM is scarce.We report the adverse events registered during TRT in 95 young patients with TM. RESULTS: These AEs included gynecomastia, documented in 41/95 (43.1%) TM patients of mild to moderate severity (90%). Persistent pain in the injection site and local reactions to testosterone (T) skin patch occurred in a third of patients. Priapism was reported in 2 patients on treatment with intramuscular T enanthate. In both patients, substitution with T gel was successful, and no recurrence during the following 24 months was observed. CONCLUSIONS: Clinicians should exercise caution when considering TRT for hypogonadal men with TM. (www.actabiomedica.it).


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Terapia de Reposição Hormonal/efeitos adversos , Hipogonadismo/tratamento farmacológico , Hipogonadismo/epidemiologia , Testosterona/efeitos adversos , Talassemia beta/epidemiologia , Adolescente , Estudos de Coortes , Comorbidade , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/fisiopatologia , Terapia de Reposição Hormonal/métodos , Humanos , Hipogonadismo/diagnóstico , Masculino , Monitorização Fisiológica/métodos , Segurança do Paciente , Prevalência , Prognóstico , Estudos Retrospectivos , Medição de Risco , Testosterona/administração & dosagem , Resultado do Tratamento , Adulto Jovem , Talassemia beta/diagnóstico
14.
Eur J Med Chem ; 176: 21-40, 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31091478

RESUMO

Male late-onset hypogonadism (LOH) is reported as one of the most common age-related diseases occurred in middle-aging men. Testosterone replacement therapy (TRT) is currently the main clinical treatment for LOH, however it has obvious side effects. A 2-methylpyrimidine-fused tricyclic diterpene analog 7 was afforded as anti-LOH hit, which was screened out from our small synthetic library. Then a series of derivates were designed and synthesized based on the hit and their effects in promoting testosterone production and cytotoxicities were evaluated in mouse TM3 Leydig cells. The most potent and safe compound 29 (SH379) was obtained, which significantly promoted the expression of the key testosterone synthesis-related enzymes StAR and 3ß-HSD. Further studies discovered that 29 could stimulate autophagy through regulating AMPK/mTOR signaling pathway. More importantly, 29 increased the testosterone levels and the sperm viability and motility in PADAM (partial androgen deficiency in aging males) rats obviously and displayed almost no side effects. Furthermore, Preliminary pharmacokinetics evaluation also indicated an excellent oral bioavailability of 29. Therefore, these methylpyrimidine-fused tricyclic diterpene analogs could be used as leads for the development of a new type of potential anti-LOH agent.


Assuntos
Diterpenos/uso terapêutico , Hipogonadismo/tratamento farmacológico , Pirimidinas/uso terapêutico , Testosterona/metabolismo , 3-Hidroxiesteroide Desidrogenases/metabolismo , Administração Oral , Animais , Linhagem Celular , Diterpenos/administração & dosagem , Diterpenos/síntese química , Diterpenos/toxicidade , Humanos , Masculino , Camundongos , Estrutura Molecular , Fosfoproteínas/metabolismo , Pirimidinas/administração & dosagem , Pirimidinas/síntese química , Pirimidinas/toxicidade , Ratos Sprague-Dawley , Glândulas Seminais/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacos , Relação Estrutura-Atividade , Testículo/efeitos dos fármacos , Testículo/patologia
15.
J Assist Reprod Genet ; 36(6): 1273-1280, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31073722

RESUMO

PURPOSE: Congenital hypogonadotropic hypogonadism (CHH) is a rare genetic disorder mostly characterized by gonadotropins release and/or action deficiencies. Both isolated (idiopathic hypogonadotropic hypogonadism) and syndromic (Kallmann) forms are identified depending on the olfactory ability. Clinical and genetic heterogeneities of CHH have been widely explored, thus improving our understanding of the disease's pathophysiology. This work aims to (1) provide a detailed clinical and hormonal description of normosmic CHH patients and (2) identify the mutation linked to the studied phenotype. PARTICIPANTS AND METHODS: We investigated three affected patients with normosmic CHH, belonging to a consanguineous Tunisian family. Patients underwent an insulin-induced hypoglycemia test. We performed whole exome sequencing to identify the causal mutation. RESULTS: At first diagnosis, a total gonadotropic deficiency was identified in all patients. The insulin-induced hypoglycemia test has also revealed a reduced cortisol secretion and complete growth hormone deficiency. At 20.8 years, one female exhibited a spontaneous recovery of the hypothalamic-pituitary-adrenal axis function, unlike her affected siblings who still depend on corticosteroid replacement therapy. Herein, we identified a novel homozygous nonstop mutation (c.1195T>C) in KISS1R gene in all affected subjects. This mutation led to the substitution of the physiologic stop codon by an arginine (p.X399R). CONCLUSIONS: Our study highlights the importance of the KISS1R signaling, in gonadotropin-releasing hormone neurons, in the control of reproductive function. Additionally, our data suggests a complex central and peripheral metabolic control of puberty, through the hypothalamic KISS1R signaling. We suggest a mutual link between the hypothalamic-pituitary-gonadal, -adrenal, and -somatotropic axes.


Assuntos
Hipogonadismo/genética , Sistema Hipotálamo-Hipofisário/metabolismo , Receptores de Kisspeptina-1/genética , Reprodução/genética , Adolescente , Corticosteroides/uso terapêutico , Adulto , Criança , Feminino , Hormônio Liberador de Gonadotropina/genética , Gonadotropinas/uso terapêutico , Humanos , Hipogonadismo/tratamento farmacológico , Hipogonadismo/patologia , Sistema Hipotálamo-Hipofisário/patologia , Masculino , Mutação , Neurônios/metabolismo , Neurônios/patologia , Linhagem , Sistema Hipófise-Suprarrenal/metabolismo , Sistema Hipófise-Suprarrenal/patologia , Sequenciamento Completo do Exoma , Adulto Jovem
16.
Andrologia ; 51(8): e13323, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31134680

RESUMO

High-fat diets (HFDs) are detrimental to steroidogenesis and male fertility. This study aimed to investigate the protective effects of melatonin (MT) treatment on testicular dysfunction in mice fed with HFD. C57BL/6J male mice were randomly divided into three groups: CTRL, HFD and HFD + MT. MT treatment mitigated the increase in body weight and adipose tissue in HFD-fed mice. Serum levels of sex hormones were improved upon MT supplementation, and the expression of the testosterone synthesis proteins, StAR and P450scc was rescued as well. MT treatment significantly up-regulated the expression of SIRT1, SOD2, and GPx4 and down-regulated the expression of GRP78 and CHOP, indicating an attenuation of oxidative stress (OS) and endoplasmic reticulum (ER) stress. In TM3 cells, MT treatment protected against H2 O2 -induced steroidogenic collapse by improving mitochondrial function and attenuating OS and ER stress. These results indicate that MT treatment can improve steroidogenesis in mice fed with HFD and may have therapeutic value in the treatment of obesity-associated hypogonadism.


Assuntos
Hipogonadismo/tratamento farmacológico , Células Intersticiais do Testículo/efeitos dos fármacos , Melatonina/administração & dosagem , Obesidade/complicações , Testosterona/biossíntese , Animais , Linhagem Celular , Enzima de Clivagem da Cadeia Lateral do Colesterol/metabolismo , Dieta Hiperlipídica/efeitos adversos , Modelos Animais de Doenças , Estresse do Retículo Endoplasmático/efeitos dos fármacos , Humanos , Peróxido de Hidrogênio/toxicidade , Hipogonadismo/etiologia , Hipogonadismo/metabolismo , Células Intersticiais do Testículo/citologia , Células Intersticiais do Testículo/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/patologia , Obesidade/etiologia , Obesidade/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Fosfoproteínas/metabolismo , Resultado do Tratamento
17.
Eur J Endocrinol ; 180(6): R201-R212, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-30959485

RESUMO

As the most important male hormone, testosterone has an impact on almost all organs and body functions. The biological effects of testosterone and the testes have been known since antiquity, long before testosterone was identified as the active agent. Practical applications of this knowledge were castration of males to produce obedient servants, for punishment, for preservation of the prepubertal soprano voice and even for treatment of diseases. Testes were used in organotherapy and transplanted as treatment for symptoms of hypogonadism on a large scale, although these practices had only placebo effects. In reaction to such malpractice in the first half of the 20th century science and the young pharmaceutical industry initiated the search for the male hormone. After several detours together with their teams in 1935, Ernst Laqueur (Amsterdam) isolated and Adolf Butenandt (Gdansk) as well as Leopold Ruzicka (Zürich) synthesized testosterone. Since then testosterone has been available for clinical use. However, when given orally, testosterone is inactivated in the liver, so that parenteral forms of administration or modifications of the molecule had to be found. Over 85 years the testosterone preparations have been slowly improved so that now physiological serum levels can be achieved.


Assuntos
Endocrinologia/história , Testosterona/história , História do Século XV , História do Século XVI , História do Século XVII , História do Século XVIII , História do Século XIX , História do Século XX , História do Século XXI , História Antiga , História Medieval , Humanos , Hipogonadismo/tratamento farmacológico , Hipogonadismo/cirurgia , Masculino , Orquiectomia/história , Testículo/fisiologia , Testículo/transplante , Testosterona/síntese química , Testosterona/uso terapêutico
19.
Georgian Med News ; (286): 77-82, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30829594

RESUMO

The percentage of men with low and subnormal blood testosterone levels (less than 12 nmol/l) is increasing with age. The injection form of testosterone undecanoate (TU) represents the first long-acting injectable testosterone medication with a satisfactory safety profile, which is administered 4 times a year, does not lead to supraphysiological increases in testosterone blood levels, with the achievement of its stable levels. The aim is to investigate the effectiveness of therapy with testosterone undecanoate in patients with hypothyroidism and androgen deficiency. Patients with hypothyroidism were divided into two subgroups depending on the prescribed TU. 26 men in the first group received four intramuscular injections of 4 ml of TU oil solution (1000 mg): the interval between the first and second injections was 6 weeks, the following two injections were made after 12 weeks each. Laboratory tests for measuring serum levels of total testosterone andluteinizing hormone (LH) after the second, third and fourth injections (2-2.5 months after the previous injection). The average total testosterone level in the blood of patients before the start of treatment was significantly lower than that of the control group.On the background of substitution therapy with testosterone, stabilization of the level of total testosterone at the reference levels in the blood of men with hypothyroidism was observed in 9 months of follow-up compared with the indicator before treatment.The average level of LH in the blood of patients with hypothyroidism and androgen deficiency did not significantly differ from that of the control group. There was no significant difference in changes of mean LH levels in the treatment regimen compared to the control group. The use of long-acting injectable long-term TU results in the normalization of total testosterone levels in men with hypothyroidism and androgen deficiency.


Assuntos
Hipogonadismo , Hipotireoidismo , Testosterona , Humanos , Hipogonadismo/tratamento farmacológico , Hipotireoidismo/tratamento farmacológico , Injeções Intramusculares , Masculino , Testosterona/sangue , Testosterona/deficiência
20.
Acta Biomed ; 90(1): 158-167, 2019 01 23.
Artigo em Inglês | MEDLINE | ID: mdl-30889170

RESUMO

BACKGROUND: Transfusion-dependent ß-thalassemia (TDT) is associated with several complications necessitating a multidisciplinary approach for diagnosis, treatment and follow-up. Hypogonadism in female TDT patients is one of the most common endocrine complications, requiring hormone replacement therapy (HRT) throughout reproductive life. Little is known about the balance of benefits versus risks of treatment with sex steroids. AIM: The aim of this manuscript is to review the action and the associated adverse effects of HRT in hypogonadal TDT females. DESIGN: Retrospective medical database records from a single centre, over a period of 38 years (January 1980 to June 2018), were reviewed. STUDY POPULATION: Forty-two cases of hypogonadism in TDT females followed in a pediatric and adolescent outpatient clinics, were in included in the study. METHODS: Auxological, clinical, laboratory, hormonal and imaging investigations were reviewed, as well as all adverse events registered during HRT. MAIN RESULTS: In general, HRT was safe for most patients. There were few minor side effects and a couple of rare but serious adverse events. CONCLUSIONS: The study provides a representative clinical profile of long-term effects of HRT in hypogonadal adolescents and young adult TDT women. Our results highlight also the need for further research in other areas for which HRT may have a role.  We hope this will contribute to a wider understanding, and potential improvement, of patient safety and quality of life.


Assuntos
Transfusão de Sangue , Terapia de Reposição Hormonal , Hipogonadismo/tratamento farmacológico , Talassemia beta/complicações , Adolescente , Adulto , Feminino , Terapia de Reposição Hormonal/efeitos adversos , Humanos , Hipogonadismo/etiologia , Fenótipo , Estudos Retrospectivos , Adulto Jovem
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