TY - JOUR
T1 - Testosterone in men with hypogonadism and transgender males
T2 - a systematic review comparing three different preparations
AU - Madsen, Milou Cecilia
AU - den Heijer, Martin
AU - Pees, Claudia
AU - Biermasz, Nienke R.
AU - Bakker, Leontine E. H.
N1 - Funding Information: This publication has been supported by the European Reference Network on Rare Endocrine Conditions (Endo-ERN), which is co-funded by the European Union’s 3rd Health Program (CHAFEA Framework Partnership Agreement No. 739527). Publisher Copyright: © 2022 The authors Published by Bioscientifica Ltd.
PY - 2022/8/1
Y1 - 2022/8/1
N2 - Testosterone therapy is the cornerstone in the care of men with hypogonadism and transgender males. Gel and intramuscular injections are most frequently used and are registered and included in the international guidelines. The specific preparation should be selected according to the patient’s preference, cost, availability, and formulation-specific properties. As the majority of men with hypogonadism and transgender males require lifelong treatment with testosterone, it is important to utilize a regimen that is effective, safe, inexpensive, and convenient to use with optimal mimicking of the physiological situation. This systematic review reviews current literature on differences between the three most used testosterone preparations in adult men with hypogonadism and transgender males. Although it appeared hardly any comparative studies have been carried out, there are indications of differences between the preparations, for example, on the stability of testosterone levels, hematocrit, bone mineral density, and patient satisfaction. However, there are no studies on the effects of testosterone replacement on endpoints such as cardiovascular disease in relation to hematocrit or osteoporotic fractures in relation to bone mineral density. The effect of testosterone therapy on health-related quality of life is strongly underexposed in the reviewed studies, while this is a highly relevant outcome measure from a patient perspective. In conclusion, current recommendations on testosterone treatment appear to be based on data primarily from non-randomized clinical studies and observational studies. The availability of reliable comparative data between the different preparations will assist in the process of individual decision-making to choose the most suitable formula.
AB - Testosterone therapy is the cornerstone in the care of men with hypogonadism and transgender males. Gel and intramuscular injections are most frequently used and are registered and included in the international guidelines. The specific preparation should be selected according to the patient’s preference, cost, availability, and formulation-specific properties. As the majority of men with hypogonadism and transgender males require lifelong treatment with testosterone, it is important to utilize a regimen that is effective, safe, inexpensive, and convenient to use with optimal mimicking of the physiological situation. This systematic review reviews current literature on differences between the three most used testosterone preparations in adult men with hypogonadism and transgender males. Although it appeared hardly any comparative studies have been carried out, there are indications of differences between the preparations, for example, on the stability of testosterone levels, hematocrit, bone mineral density, and patient satisfaction. However, there are no studies on the effects of testosterone replacement on endpoints such as cardiovascular disease in relation to hematocrit or osteoporotic fractures in relation to bone mineral density. The effect of testosterone therapy on health-related quality of life is strongly underexposed in the reviewed studies, while this is a highly relevant outcome measure from a patient perspective. In conclusion, current recommendations on testosterone treatment appear to be based on data primarily from non-randomized clinical studies and observational studies. The availability of reliable comparative data between the different preparations will assist in the process of individual decision-making to choose the most suitable formula.
KW - long-acting injections
KW - men with hypogonadism
KW - short-acting injections
KW - testosterone therapy
KW - transdermal gel
KW - transgender males
UR - http://www.scopus.com/inward/record.url?scp=85134823619&partnerID=8YFLogxK
U2 - https://doi.org/10.1530/EC-22-0112
DO - https://doi.org/10.1530/EC-22-0112
M3 - Review article
C2 - 35904217
SN - 2049-3614
VL - 11
JO - Endocrine Connections
JF - Endocrine Connections
IS - 8
M1 - e220112
ER -