testosterone treatment

Testosterone Treatment and Fractures in Men with Hypogonadism

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Abstract

Background

Testosterone treatment in men with hypogonadism improves bone density and quality, but trials with a sufficiently large sample and a sufficiently long duration to determine the effect of testosterone on the incidence of fractures are needed.

Methods

In a subtrial of a double-blind, randomized, placebo-controlled trial that assessed the cardiovascular safety of testosterone treatment in middle-aged and older men with hypogonadism, we examined the risk of clinical fracture in a time-to-event analysis. Eligible men were 45 to 80 years of age with preexisting, or high risk of, cardiovascular disease; one or more symptoms of hypogonadism; and two morning testosterone concentrations of less than 300 ng per deciliter (10.4 nmol per liter), in fasting plasma samples obtained at least 48 hours apart. Participants were randomly assigned to apply a testosterone or placebo gel daily. At every visit, participants were asked if they had had a fracture since the previous visit. If they had, medical records were obtained and adjudicated.

Results

The full-analysis population included 5204 participants (2601 in the testosterone group and 2603 in the placebo group). After a median follow-up of 3.19 years, a clinical fracture had occurred in 91 participants (3.50%) in the testosterone group and 64 participants (2.46%) in the placebo group (hazard ratio, 1.43; 95% confidence interval, 1.04 to 1.97). The fracture incidence also appeared to be higher in the testosterone group for all other fracture end points.

Conclusions

Among middle-aged and older men with hypogonadism, testosterone treatment did not result in a lower incidence of clinical fracture than placebo. The fracture incidence was numerically higher among men who received testosterone than among those who received placebo

Testosterone Treatment and Fractures in Men with Hypogonadism

Posted by

0


Abstract

Background

Testosterone treatment in men with hypogonadism improves bone density and quality, but trials with a sufficiently large sample and a sufficiently long duration to determine the effect of testosterone on the incidence of fractures are needed.

Methods

In a subtrial of a double-blind, randomized, placebo-controlled trial that assessed the cardiovascular safety of testosterone treatment in middle-aged and older men with hypogonadism, we examined the risk of clinical fracture in a time-to-event analysis. Eligible men were 45 to 80 years of age with preexisting, or high risk of, cardiovascular disease; one or more symptoms of hypogonadism; and two morning testosterone concentrations of less than 300 ng per deciliter (10.4 nmol per liter), in fasting plasma samples obtained at least 48 hours apart. Participants were randomly assigned to apply a testosterone or placebo gel daily. At every visit, participants were asked if they had had a fracture since the previous visit. If they had, medical records were obtained and adjudicated.

Results

The full-analysis population included 5204 participants (2601 in the testosterone group and 2603 in the placebo group). After a median follow-up of 3.19 years, a clinical fracture had occurred in 91 participants (3.50%) in the testosterone group and 64 participants (2.46%) in the placebo group (hazard ratio, 1.43; 95% confidence interval, 1.04 to 1.97). The fracture incidence also appeared to be higher in the testosterone group for all other fracture end points.

Conclusions

Among middle-aged and older men with hypogonadism, testosterone treatment did not result in a lower incidence of clinical fracture than placebo. The fracture incidence was numerically higher among men who received testosterone than among those who received placebo.

Female-to-male transsexuals ‘start to think like men’ after hormone treatment

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Study finds that testosterone decreased verbal and multitasking abilities whilst boosting spatial awareness

Exposure to the male hormone almost immediately reduced the volume of grey matter in the two regions of the brain linked to language processing

Exposure to the male hormone almost immediately reduced the volume of grey matter in the two regions of the brain linked to language processing

It is a commonly held belief, certainly among the fairer sex, that women are better at multitasking than men.

And scientists have now discovered that women undergoing a sex change start to think more like men after treatment as their brains are rewired.

Researchers studied the brains of 18 female-to-male transsexuals before and after four weeks of testosterone treatment.

They found that qualities more traditionally attributed to women, such asverbal and multitasking skills, diminished, while others increased.

Exposure to the male hormone almost immediately reduced the volume of grey matter in the two regions of the brain linked to language processing.

At the same time, connections between the two regions became stronger, increasing spatial ability.

Researcher Professor Rupert Lanzenberger, from the University of Vienna, said: “What we see is a real quantitative difference in brain structure after prolonged exposure to testosterone. This would have been impossible to understand without looking at a transsexual population.

“In more general terms, these findings may suggest that the genuine difference between the brains of women and men is substantially attributable to the effects of circulating sex hormones. Moreover, the hormonal influence on human brain structure goes beyond early developmental phases and is still present in adulthood.”

Although it has long been believed that women are better at certain skills than men, and vice versa, little scientific research has gone the theory.

Experts have previously suggested that women’s apparent superiority at juggling tasks has its roots in evolution, when in the Stone Age men went out hunting and women stayed at the base looking after the children, the home and gathering food.

And many linguists believe that language practices are more largely based on social and cultural factors.

But the study reinforces the idea that “men are from Mars and women from Venus“ because of the way their brains are wired.

The findings were presented at the annual meeting of the European College of Neuropsychopharmacology (ECNP) in Amsterdam, the Netherlands.

Commenting on behalf of the ECNP communications committee, Dr Kamilla Miskowiak, from Copenhagen University Hospital, said: “It is well known that language development differs between girls and boys and that this is related to gender-related differences in brain maturation.

“However, this intriguing neuroimaging study of transsexuals before and after their female-to-male gender reassignment suggests that even adult men and women differ in brain structure within regions involved in language and speech.

“In particular, female-to-male gender reassignment resulted in local brain matter decrease within language processing regions, which may explain why verbal abilities are often stronger in women.”