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Hypogonadism May Result After Prostatic Disease: Presented at AACE

By Mike Fillon

CHICAGO, I.L. -- May 1, 2006 -- A new study shows that men with a history of prostatic disease are more likely to have hypogonadism than patients who do not have a history of prostatic disease, according to results of the Hypogonadism in Males (HIM) study, presented here at the annual meeting of the American Association of Clinical Endocrinologists (AACE).

Hypogonadism, defined as serum total testosterone (TT) <300 ng/dL, can have negative impact on quality of life. Previous longitudinal studies have shown a progressive increase in the prevalence of hypogonadism with advancing age.

According to study author, Sherwyn L. Schwartz, MD, director, Diabetes and Glandular Disease Research Center, San Antonio, Texas, United States, not all men become hypogonadal as they age, and not all of those whose testosterone concentrations decline to hypogonadal range experience clinical symptoms of hypogonadism.

The primary goal of the HIM study was to estimate the prevalence of hypogonadism in a general population of men presenting to primary care practices. This analysis compared the prevalence of hypogonadism in men with a history of prostatic disease and in the overall patient population of men in the HIM study.

Between November 2003 and January 2004, 2162 men aged 45 years or older were recruited who had an appointment between 8 AM and noon from 95 primary care centers over a 2-week period. From a single morning draw, blood was assayed for TT, free testosterone (FT), and bioavailable testosterone (BAT.)

Researchers recorded symptoms associated with hypogonadism, including sexual dysfunction, fatigue, and mood changes. Prevalence rates of hypogonadism were estimated for the total sample and specific subsets, including those with predesignated concomitant conditions.

The crude prevalence of hypogonadism based on TT was 38.7% (836 of 2162 patients with evaluable TT). Similar prevalence rates were reported based on FT and BAT concentrations. Eighty patients were receiving testosterone treatment.

Among men not receiving testosterone (untreated), 756 (36.3%) had TT <300 ng/dL. The prevalence of hypogonadism observed in untreated patients with comorbid prostatic diseases or disorders was 41.3% (159/385). The odds ratio that men with prostatic disease/disorders had hypogonadism (1.29) was statistically significant (P <.05) compared with men who had no history of this condition.

A smaller proportion of men with prostatic disease were eugonadal (58.7%) than the proportion of men without prostatic disease who were eugonadal (64.7%).

The prevalence of hypogonadism in those untreated men reporting decrease in ability or frequency to perform sexually was 41.3%, decrease in sexual desire or libido was 39.8%, physical exhaustion/lacking vitality was 41.4%, and decline in general feeling of well being was 39.8%.

Dr. Schwartz said men with prostatic diseases should be evaluated for hypogonadism. He recommends that larger studies be undertaken to further examine the relationship.

Funding for the study provided by Solvay Pharmaceuticals, Inc.


[Presentation title: Association of Low Testosterone With Prostatic Disease or Disorder: Data from the Hypogonadism in Males HIM) Study. Abstract 106]

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