Numerous testosterone (T) formulations are available, each with differing effects on serum parameters.
The aim of this study was to compare the long-term effects of topical, injectable, and implantable pellet T formulations in hypogonadal men.
Retrospective review of hypogonadal men treated with a single T formulation was performed: 47 men on T gels, 57 on injectable T, and 74 on T pellets were identified. Total T (TT), calculated free T (FT), estradiol (E), hemoglobin (Hgb), hematocrit (Hct), prostate-specific antigen (PSA), total cholesterol (Tchol), triglycerides (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol were evaluated at baseline and every 3-6 months for 3 years. Serum parameters were compared using a mixed model linear regression for repeated measures.
Effects of topical, injectable, and pellet T formulations on serum hormone levels, Hgb, Hct, lipid parameters and PSA.
Men in the injectable T group were younger (42. 5 ± 12. 3 years) than in the gel (54. 1 ± 9. 8 years) or pellet groups (53. 8 ± 13. 0 years), and baseline FT, Hgb, and Hct were higher in the injectable T group than in gel or pellet groups. Increases in TT and FT were observed throughout follow-up in all groups. Increases in E were observed at in all T groups and throughout follow-up in injectable and gel groups. No PSA increases were observed. Erythrocytosis (Hct > 50%) was more common with injectable T (66. 7%) than with T gels (12. 8%) or pellets (35. 1%, P < 0. 0001). Transient changes in cholesterol, TG, and LDL were observed, and no significant changes were seen in HDL for any group.
All T formulations increase serum T and FT. More significant increases in E occur with injectable T and T gels. Changes in Hgb and Hct are most significant with injectable T, and effects on lipids are variable and inconsistent. Selection of T formulations must account for individual patient preferences and the effects of each formulation.
Sexual medicine. 2015 Aug 12 [Epub]
Alexander W Pastuszak, Lissette P Gomez, Jason M Scovell, Mohit Khera, Dolores J Lamb, Larry I Lipshultz
Scott Department of Urology, Baylor College of Medicine Houston, TX, USA ; Center for Reproductive Medicine, Baylor College of Medicine Houston, TX, USA. , Scott Department of Urology, Baylor College of Medicine Houston, TX, USA ; Center for Reproductive Medicine, Baylor College of Medicine Houston, TX, USA. , Scott Department of Urology, Baylor College of Medicine Houston, TX, USA. , Scott Department of Urology, Baylor College of Medicine Houston, TX, USA. , Scott Department of Urology, Baylor College of Medicine Houston, TX, USA ; Center for Reproductive Medicine, Baylor College of Medicine Houston, TX, USA ; Department of Cell Biology, Baylor College of Medicine Houston, TX, USA. , Scott Department of Urology, Baylor College of Medicine Houston, TX, USA ; Center for Reproductive Medicine, Baylor College of Medicine Houston, TX, USA.