Advertisement

Androgen Deficiency

  • Glenn R. Cunningham
  • Max Hirshkowitz

Abstract

The classic belief is that androgen (of which testosterone is the major component) primarily mediates libido. Androgen deficiency has long been known to contribute to, but not necessarily be the sole underlying cause of, erectile failure. Clinical studies provide information for understanding the role of androgens in human sexual function. Loss of sexual drive and desire in association with hypogonadism has long been recognized, and self-reports have verified clinical observations.1–3 The nocturnal penile tumescence study has provided a sensitive, objective, physiologic index for studying erectile capability and screening androgen deficiency.4,5

Keywords

Sleep Apnea Androgen Deficiency Symptomatic Benign Prostatic Hyperplasia Testosterone Enanthate Testosterone Undecanoate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Davidson JM, Chen J J, Crapo L, et al. Hormonal changes and sexual function in aging men. J Clin Endocrinol Metab 1983; 57: 71–77.PubMedCrossRefGoogle Scholar
  2. 2.
    Davidson JM, Camargo CA, Smith ER. Effects of androgen on sexual behavior in hypogonadal men. J Clin Endocrinol Metab 1979; 48:955–962.PubMedCrossRefGoogle Scholar
  3. 3.
    Davidson JM, Kwan M, Greenleaf WJ. Hormonal replacement and sexuality in men. Clin Endocrinol Metab 1982; 11: 599–623.PubMedCrossRefGoogle Scholar
  4. 4.
    Cunningham GR, Karacan I, Ware JC, et al. The relationships between serum testosterone and prolactin levels and nocturnal penile tumescence (NPT) in impotent men. J Androl 1982; 3: 241–247.Google Scholar
  5. 5.
    Fenwick PBC, Mercer S, Grant R, et al. Nocturnal penile tumescence and serum testosterone levels. Arch Sex Behav 1986; 15: 13.PubMedCrossRefGoogle Scholar
  6. 6.
    Plymate SR, Tenover JS, Bremner WJ. Orcadian variation in testosterone, sex hormone-binding globulin, and calculated non-sex hormone-binding globulin bound testosterone in healthy young and elderly men. J Androl 1989; 10: 366–371.PubMedGoogle Scholar
  7. 7.
    Murray FR, Cameron DF, Vogel RB, et al. The pituitary-testicular axis at rest and during moderate exercise in males with diabetes mellitus and normal sexual function. J Androl 1988; 9: 197–206.PubMedGoogle Scholar
  8. 8.
    Manni A, Pardridge WM, Cefalu W, et al. Bioavailability of albumin-bound testosterone. J Clin Endocrinol Metab 1985; 61: 705–710.PubMedCrossRefGoogle Scholar
  9. 9.
    Ekins R. Measurement of free hormones in blood. Endocr Rev 1990; 11: 5–46.PubMedCrossRefGoogle Scholar
  10. 10.
    Mendel CM. The free hormone hypothesis distinction from the free hormone transport hypothesis./ Androl 1992; 13: 107–116.Google Scholar
  11. 11.
    Goldzieher JW, Dozier TS, Smith KD, Steinberger E. Improving the diagnostic reliability of rapidly fluctuating plasma hormone levels by optimized multiple-sampling techniques. J Clin Endocrinol Metab 1976; 43: 824.PubMedCrossRefGoogle Scholar
  12. 12.
    Bain J, Langevin R, D’Costa M, Sanders RM, Hucker S. Serum pituitary and steroid hormone levels in the adult male: one value is as good as the mean of three. Fertil Steril 1988; 49: 123–126.PubMedGoogle Scholar
  13. 13.
    Vermeulen A, Verdonck G. Representativeness of a single point plasma testosterone level for the long-term hormonal milieu in men. J Clin Endocrinol Metab 1992; 74: 939–942.PubMedCrossRefGoogle Scholar
  14. 14.
    Korenman SG, Morley JE, Mooradian AD, et al. Secondary hypogonadism in older men: its relation to impotence. J Clin Endocrinol Metab 1990; 71: 963–969.PubMedCrossRefGoogle Scholar
  15. 15.
    Guay AT, Bansal S, Hodge MB. Possible hypothalamic impotence. Male counterpart to hypothalamic amenorrhea? Urology 1991; 38: 317–322.PubMedCrossRefGoogle Scholar
  16. 16.
    Tenover JS. Effects of testosterone supplementation in the aging male. J Clin Endocrinol Metab 1992; 75: 1092–1098.PubMedCrossRefGoogle Scholar
  17. 17.
    Mulligan T, Schmitt B. Testosterone for erectile failure. J Gen Intern Med 1993; 8: 517–521.PubMedCrossRefGoogle Scholar
  18. 18.
    Clopper RR, Voorhess ML, MacGillivray MH, Lee PA, Mills B. Psychosexual behavior in hy-popituitary men: a controlled comparison of gonadotropin and testosterone replacement. Psychoneuroendocrinology 1993; 18: 149–161.PubMedCrossRefGoogle Scholar
  19. 19.
    Bancroft J, Wu FCW. Changes in erectile responsiveness during androgen replacement therapy. Arch Sex Behav 1983; 12: 59–66.PubMedCrossRefGoogle Scholar
  20. 20.
    Eyal A, Ish-Shalom S, Hoch Z, Hochberg Z. Androgen therapy in hypogonadotrophic hypogonadism: time course of erectosexual functions. Arch Androl 1988; 20: 163–169.PubMedCrossRefGoogle Scholar
  21. 21.
    Carani C, Bancroft J, Granata A, et al. Testosterone and erectile function, nocturnal penile tumescence and rigidity, and erectile response to usual erotic stimuli in hypogonadal men. Psychoneuroendocrinology 1992; 17:647–654.PubMedCrossRefGoogle Scholar
  22. 22.
    Greenstein A, Plymate SR, Katz PG. Visually stimulated erection in castrated men. J Urol 1995; 153: 650–652.PubMedCrossRefGoogle Scholar
  23. 23.
    Rowland DL, Greenleaf WJ, Dorfman IJ, Davidson JM. Aging and sexual function in men. Arch Sex Behav 1993; 22: 545–557.PubMedCrossRefGoogle Scholar
  24. 24.
    O’Carroll R, Shapiro C, Bancroft J. Androgens, behaviour and nocturnal erection in hypogonadal men: the effects of varying the replacement dose. Clin Endocrinol 1985; 23: 527–538.CrossRefGoogle Scholar
  25. 25.
    Cunningham GR, Hirshkowitz M, Korenman SG, Karacan I. Testosterone replacement therapy and sleep-related erections in hypogonadal men. J Clin Endocrinol Metab 1990; 70: 792–797.PubMedCrossRefGoogle Scholar
  26. 26.
    Thigpen A-E, Silver RI, Guileyardo JM, et al. Tissue distribution and ontogeny of steroid 5a-reductase isozyme expression. J Clin Invest 1993; 92: 903–910.PubMedCrossRefGoogle Scholar
  27. 27.
    Ross RK, Bernstein L, Lobo RA, et al. 5-alpha-reductase activity and risk of prostate cancer among Japanese and US white and black males. Lancet 1992; 339: 887–889.PubMedCrossRefGoogle Scholar
  28. 28.
    Lookingbill DP, Demers LM, Wang C, et al. Clinical and biochemical parameters of androgen action in normal healthy Caucasian versus Chinese subjects. J Clin Endocrinol Metab 1991; 72: 1242–1248.PubMedCrossRefGoogle Scholar
  29. 29.
    Sasagawa I, Nakada T, Kazama T, et al. Volume change of the prostate and seminal vesicles in male hypogonadism after androgen replacement therapy. Int Urol Nephrol 1990; 22: 279–284.PubMedCrossRefGoogle Scholar
  30. 30.
    Behre HM, Bohmeyer J, Nieschlag E. Prostate volume in testosterone-treated and untreated hypogonadal men in comparison to age-matched normal controls. Clin Endocrinol 1994; 40: 341–349.CrossRefGoogle Scholar
  31. 31.
    Parker MW, Johanson AJ, Rogol AD, Kaiser DL, Blizzard RM. Effect of testosterone on somatomedin-C concentrations in prepubertal boys. J Clin Endocrinol Metab 1984; 58: 87–90.PubMedCrossRefGoogle Scholar
  32. 32.
    Weissbeger AJ, Ho KKY. Activation of the somatotropic axis by testosterone in adult males: evidence for the role of aromatization. J Clin Endocrinol Metab 1993; 76: 1407–1412.CrossRefGoogle Scholar
  33. 33.
    Keenan BS, Richards GE, Ponder SW. Androgen-stimulated pubertal growth: the effects of testosterone and dihydrotestosterone on growth hormone and insulin-like growth factor-I in the treatment of short stature and delayed puberty. J Clin Endocrinol Metab 1993; 76: 996–1001.PubMedCrossRefGoogle Scholar
  34. 34.
    Finkelstein JS, Neer RM, Biller BMK, Crawford JD, Klibanski A. Osteopenia in men with a history of delayed puberty. N Engl J Med 1992; 326: 600–604.PubMedCrossRefGoogle Scholar
  35. 35.
    Finkelstein JS, Klibanski A, Neer RM, et al. Osteoporosis in men with idiopathic hypo-gonadotropic hypogonadism. Ann Intern Med 1987; 106: 354–361.PubMedGoogle Scholar
  36. 36.
    Wong FH, Pun KK, Wang C. Loss of bone mass in patients with Klinefelter’s syndrome despite sufficient testosterone replacement. Osteoporosis Int 1993; 3: 3–7.CrossRefGoogle Scholar
  37. 37.
    Finklestein JS, Klibanski A, Neer RM, et al. Increases in bone density during treatment of men with idiopathic hypogonadotropic hypogonadism. J Clin Endocrinol Metab 1989; 69: 776–783.CrossRefGoogle Scholar
  38. 38.
    Arisaka O, Arisaka M, Nakayama Y, Fujiwam S, Yabuta K. Effect of testosterone on bone density and bone metabolism in adolescent male hypogonadism. Metabolism 1995; 44: 419–423.PubMedCrossRefGoogle Scholar
  39. 39.
    Bourguignon J-P. Linear growth as a function of age at onset of puberty and sex steroid dosage: therapeutic implications. EndocrRev 1988; 9: 467–488.CrossRefGoogle Scholar
  40. 40.
    Smith EP, Boyd J, Frank GR, et al. Estrogen resistance caused by a mutation in the estrogen-receptor gene in a man. N Engl J Med 1994; 331: 1056–1061.PubMedCrossRefGoogle Scholar
  41. 41.
    Morishima A, Grumbach MM, Simpson ER, Fisher C, Qin K. Aromatase deficiency in male and female siblings caused by a novel mutation and the physiological role of estrogens. J Clin Endocrinol Metab 1995; 80: 3689–3698.PubMedCrossRefGoogle Scholar
  42. 42.
    Zachman M, Prader A, Sobel EH, et al. Pubertal growth in patients with androgen insensitiv-ity: indirect evidence for the importance of estrogens in pubertal growth of girls. J Pediatr 1986; 108: 694–697.CrossRefGoogle Scholar
  43. 43.
    Kasperk CH, Wergedal JE, Farley JR, et al. Androgens directly stimulate proliferation of bone cells in vitro. Endocrinology 1989; 124: 1576–1578.PubMedCrossRefGoogle Scholar
  44. 44.
    Kasperk C, Fitzsimmons R, Strong D. Studies of the mechanism by which androgens enhance mitogenesis and differentiation in bone cells. J Clin Endocrinol Metab 1990; 71: 1322–1329.PubMedCrossRefGoogle Scholar
  45. 45.
    Bellido T, Jilka RL, Boyce BF, et al. Regulation of interleukin-6, osteoclastogenesis, and bone mass by androgens. J Clin Invest 1995; 95: 2886–2895.PubMedCrossRefGoogle Scholar
  46. 46.
    Kelepouris N, Harper KD, Gannon F, Kaplan FS, Haddad JG. Severe osteoporosis in men. Ann Intern Med 1995; 123: 452–460.PubMedGoogle Scholar
  47. 47.
    Jackson JA, Riggs MW, Spiekerman AM. Testosterone deficiency as a risk factor for hip fractures in men: a case-control study. Am J Med Sei 1992; 304: 4–8.CrossRefGoogle Scholar
  48. 48.
    Goldray D, Weisman Y, Jaccard N, et al. Decreased bone density in elderly men treated with the gonadotropin-releasing hormone agonist decapeptyl (d-Trp6-GnRH). J Clin Endocrinol Metab 1993; 76: 288–290.PubMedCrossRefGoogle Scholar
  49. 49.
    Chauhan AK, Katiyar BC, Misra S, Thacker AK, Singh NK. Muscle dysfunction in male hypogonadism. Acta Neurol Scand 1986; 73: 466–471.PubMedCrossRefGoogle Scholar
  50. 50.
    Kenyon AT, Knowlton K, Sandiford I, Koch FC, Lotwin G. A comparative study of the metabolic effects of testosterone propionate in normal men and women and in eunuchoidism. Endocrinology 1940; 26: 26–45.CrossRefGoogle Scholar
  51. 51.
    Sandiford I, Knowlton K, Kenyon AT. Basal heat production in hypogonadism in men and its increase by protracted treatment with testosterone propionate. J Clin Endocrinol 1941; 12: 931–939.CrossRefGoogle Scholar
  52. 52.
    Tenover JS. Effects of testosterone supplementation in the aging male. J Clin Endocrinol Metab 1992; 75: 1092–1098.PubMedCrossRefGoogle Scholar
  53. 53.
    Krabbe S, Christensen T, Worm J, Christiansen C, Transbol I. Relationship between haemoglobin and serum testosterone in normal children and adolescents and in boys with delayed puberty. Acta Paediatr Scand 1978; 67: 655–658.PubMedCrossRefGoogle Scholar
  54. 54.
    Alexanian R. Erythropoietin and erythropoie-sis in anemic man following androgens. Blood 1969; 33: 564–572.PubMedGoogle Scholar
  55. 55.
    Weber JP, Walsh PC, Peters CA, et al. Effect of reversible androgen deprivation on hemoglobin and serum immunoreactive erythropoietin in men. Am J Hematol 1991; 36: 190–194.PubMedCrossRefGoogle Scholar
  56. 56.
    Moriyama Y, Fisher JW. Effects of testosterone and erythropoietin on erythroid colony formation in human bone marrow cultures. Blood 1975; 45: 665–670.PubMedGoogle Scholar
  57. 57.
    Aboudkhil S, Bureau JP, Garrelly L, et al. Effects of castration, depo-testosterone and cyproterone acetate on lymphocyte T subsets in mouse thymus and spleen. Scand J Immunol 1991; 34: 647–653.PubMedCrossRefGoogle Scholar
  58. 58.
    Kumar N, Shan L-X, Hardy MP, Bardin CW. Mechanism of androgen-induced thymolysis in rats. Endocrinology 1995; 136: 4887–4893.PubMedCrossRefGoogle Scholar
  59. 59.
    Marin P, Oden B, Bjorntorp P. Assimilation and mobilization of triglycerides in subcutaneous abdominal and femoral adipose tissue in vivo in men: effects of androgens. J Clin Endocrinol Metab 1995; 80: 239–243.PubMedCrossRefGoogle Scholar
  60. 60.
    Kirkland RT, Keenan BS, Probstfield JL, et al. Decrease in plasma high-density lipoprotein cholesterol levels at puberty in boys with delayed adolescence. JAMA 1987; 257: 502–507.PubMedCrossRefGoogle Scholar
  61. 61.
    Sorva R, Kuusi T, Dunkel L, et al. Effects of endogenous sex steroids on serum lipoproteins and postheparin plasma lipolytic enzymes. J Clin Endocrinol Metab 1988; 66: 408–413.PubMedCrossRefGoogle Scholar
  62. 62.
    Oppenheim DS, Greenspan SL, Zervas NT, Schoenfeld DA, Klibanski A. Elevated serum lipids in hypogonadal men with and without hyperprolactinemia. Ann Intern Med 1989; 111: 288–292.PubMedGoogle Scholar
  63. 63.
    Goldberg RB, Rabin D, Alexander AN, et al. Suppression of plasma testosterone leads to an increase in serum total cholesterol and high density lipoprotein cholesterol and apolipo-proteins A I and B. J Clin Endocrinol Metab 1985; 60: 203.PubMedCrossRefGoogle Scholar
  64. 64.
    Bagatell CJ, Knopp RH, Vale WW, Rivier JE, Brenmer WJ. Physiologic testosterone levels in normal men suppress high-density lipoprotein cholesterol levels. Ann Intern Med 1992; 116: 967–973.PubMedGoogle Scholar
  65. 65.
    Sorva R, Kuusi T, Taskinen M-R, et al. Testosterone substitution increases the activity of lipoprotein lipase and hepatic lipase in hypogonadal males. Atherosclerosis 1988; 69: 191–197.PubMedCrossRefGoogle Scholar
  66. 66.
    Moorjani S, Dupont A, Labrie F, et al. Changes in plasma lipoproteins during various androgen suppression therapies in men with prostatic carcinoma: effects of orchiectomy, estrogen, and combination treatment with luteinizing hormone-releasing hormone and flutamide. J Clin Endocrinol Metab 1989; 66: 314–322.CrossRefGoogle Scholar
  67. 67.
    Polderman KH, Coen DA, Stehouwer A. Influence of sex hormones on plasma endothelin levels. Ann Intern Med 1993; 118: 429–432.PubMedGoogle Scholar
  68. 68.
    Fujimoto R, Moiimoto I, Morita E, et al. Androgen receptors, 5 alpha-reductase activity and androgen-dependent proliferation of vascular smooth muscle cells. J Steroid Biochem Mol Biol 1994; 50: 169–174.PubMedCrossRefGoogle Scholar
  69. 69.
    Bayard F, Clamens S, Meggetto F, et al. Estrogen synthesis, estrogen metabolism, and functional estrogen receptors in rat arterial smooth muscle cells in culture. Endocrinology 1995; 136: 1523–1529.PubMedCrossRefGoogle Scholar
  70. 70.
    Burger HG, deKretser DM, Hudson B, et al. Effects of preceding androgen therapy on testicular response to human pituitary gonadotropin in hypogonadotropic hypogonadism: a study of three patients. Fertil Steril 1981; 35: 64–68.PubMedGoogle Scholar
  71. 71.
    Greenspan SL, Oppenheim DS, Klibanski A. Importance of gonadal steroids to bone mass in men with hyperprolactinemic hypogonadism. Ann Intern Med 1989; 110: 526–531.PubMedGoogle Scholar
  72. 72.
    Santamaria JD, Prior JC, Fleetham JA. Reversible reproductive dysfuction in men with obstructive sleep apnea. Clin Endocrinol 1988; 28: 461–470.CrossRefGoogle Scholar
  73. 73.
    Wortsman J, Eagleton LE, Rosner W, Dufau ML. Mechanism for the hypotestosteronemia of the sleep apnea syndrome. Am J Med Sei 1987; 293: 221–225.CrossRefGoogle Scholar
  74. 74.
    Grunstein RR, Handelsman DJ, Lawrence SJ, et al. Neuroendocrine dysfunction in sleep apnea: reversal by continuous positive airways pressure therapy. J Clin Endocrinol Metab 1989; 68: 352–358.PubMedCrossRefGoogle Scholar
  75. 75.
    Matsumoto AM, Sandblom RE, Schoene RB, et al. Testosterone replacement in hypogonadal men: effects on obstructive sleep apnea, respiratory drives, and sleep. Clin Endocrinol 1985; 22: 713–721.CrossRefGoogle Scholar
  76. 76.
    Schneider BK, Pickett CK, Zwillich CW, et al. Influence of testosterone on breathing during sleep. J Appl Physiol 1986; 61: 618–623.PubMedGoogle Scholar
  77. 77.
    Cistuli PA, Grunstein RR, Sullivan CE. Effect of testosterone administration on upper airway collapsibility during sleep. Am J Respir Crit Care Med 1994; 149: 530–532.Google Scholar
  78. 78.
    Matsumoto AM. Effects of chronic testosterone administration in normal men: safety and efficacy of high dosage testosterone and parallel dose-dependent suppression of luteinizing hormone, follicle-stimulating hormone, and sperm production. J Clin Endocrinol Metab 1990; 70: 282–287.PubMedCrossRefGoogle Scholar
  79. 79.
    Woo JP, Gu FL. The prostate 41–75 years postcastration: an analysis of 26 eunuchs. Chin Med J; 100: 271–272.Google Scholar
  80. 80.
    Berry SJ, Coffey DS, Walsh PC, Ewing LL. The development of human benign prostatic hyperplasia with age. J Urol 1984; 132: 474–478.PubMedGoogle Scholar
  81. 81.
    Sakr WA, Haas GP, Cassin BF, Pontes JE, Crissman JD. The frequency of carcinoma and intraepithelial neoplasia of the prostate in young male patients. J Urol 1993; 150: 379–385.PubMedGoogle Scholar
  82. 82.
    Breslow N, Chang CW, Dhom G, et al. Latent carcinoma of prostate at autopsy in seven areas. Int J Cancer 1977; 20: 680–688.PubMedCrossRefGoogle Scholar
  83. 83.
    Carter HB, Pearson JD, Metter EJ, et al. Longitudinal evaluation of serum androgen levels in men with and without prostate cancer. Prostate 1995; 27: 25–31.PubMedCrossRefGoogle Scholar
  84. 84.
    Drinka PJ, Jochen AL, Cuisinier M. Polycythemia as a complication of testosterone replacement therapy in nursing home men with low testosterone levels. J Am Geriatr Soc 1995; 43: 899–901.PubMedGoogle Scholar
  85. 85.
    Krauss DJ, Taub HA, Lantinga I-J, Dunsky MH, Kelly CM. Risks of blood volume changes in hypogonadal men treated with testosterone enanthate for erectile impotence. J Urol 1991; 146: 1566–1570.PubMedGoogle Scholar
  86. 86.
    Semple Pd’A, Lowe GDO, Patterson J, et al. Comparison of cerebral blood flow after venesection of bronchitic secondary poly-cythaemic and primary polycythaemic patients. Scott Med J 1983; 28: 332–337.PubMedGoogle Scholar
  87. 87.
    Anderson S-O, Adami H-O, Bergstrom R, Wide L. Serum pituitary and sex steroid hormone levels in the etiology of prostatic cancer—a population-based case control study. Br J Cancer 1993; 68: 97–102.CrossRefGoogle Scholar
  88. 88.
    Fowler JE Jr, Whitmore WF Jr. The response of metastatic adenocarcinoma of the prostate to exogenous testosterone. J Urol 1981; 126: 372–375.PubMedGoogle Scholar
  89. 89.
    Manni A, Santen RJ, Boucher AE, et al. Androgen depletion and repletion as a means of potentiating the effect of cytotoxic chemotherapy in advanced prostate cancer. J Steroid Biochem 1987; 27: 551–556.PubMedCrossRefGoogle Scholar
  90. 90.
    Roberts JT, Essenhigh DM. Adenocarcinoma of prostate in 40-year-old body-builder. Lancet 1986; 2: 742.PubMedCrossRefGoogle Scholar
  91. 91.
    Hamalainen E, Adlercreutz H, Puska P, Pietinen P. Diet and serum sex hormones in healthy men. J Steroid Biochem 1984; 20: 459–464.PubMedCrossRefGoogle Scholar
  92. 92.
    Gooren LG. A ten-year safety study of the oral androgen testosterone undecanoate. J Androl 1994; 15: 212–215.PubMedGoogle Scholar
  93. 93.
    Korenman SG, Viosca SP, Garza D, et al. Androgen therapy of hypogonadal men with transscrotal testosterone systems. Am J Med 1987; 83: 471–478.PubMedCrossRefGoogle Scholar
  94. 94.
    Cunningham GR, Snyder PJ, Atkinson LE. Testosterone transdermal delivery system. In: Bhasin S. et al, eds. Pharmacology, Biology, and Clinical Application of Androgens. New York: Wiley-Liss; 1996: 437–448.Google Scholar
  95. 95.
    Meikle AW, Mazer NA, Moellmer JF, et al. Enhanced transdermal delivery of testosterone across nonscrotal skin produces physiological concentrations of testosterone and its metabolites in hypogonadal men. J Clin Endocrinol Metab 1992; 74: 623–628.PubMedCrossRefGoogle Scholar
  96. 96.
    Meikle AW, Arver S, Dobs AS, Sanders SW, Mazer NA. ANDRODERM: A permeation enhanced non-scrotal testosterone transdermal system for the treatment of male hypo-gonadism. In: Bhasin et al, eds. Pharmacology, Biology, and Clinical Application of Androgens. New York: Wiley-Liss; 1996: 449–57.Google Scholar
  97. 97.
    de Lignieres B. Transdermal dihydrotes-tosterone treatment of “andropause.” Ann Med 1993; 25: 235–241.PubMedCrossRefGoogle Scholar
  98. 98.
    Choi SK, Han SW, Kim DH, de Lignieres B. Transdermal dihydrotestosterone therapy and its effects on patients with microphallus. J Urol 1993; 150: 657–660.PubMedGoogle Scholar
  99. 99.
    Gerrity M, Freund M, Peterson RN, Falvo RE. The physiologic effects of testosterone in hydrogenated soybean oil vehicle as compared to free testosterone, testosterone propionate, and testosterone enanthate in a conventional oil vehicle. J Androl 1982; 3: 221–226.Google Scholar
  100. 100.
    Schultel-Beerbuhl M, Nieschlag E. Comparison of testosterone, dihydrotestosterone, luteinizing hormone, and follicle-stimulating hormone in serum after injection of testosterone enanthate or testosterone cypionate. Fertil Steril 1980; 33: 201–203.Google Scholar
  101. 101.
    Cunningham GR, Silverman V, Kohler PO. Gonadotropin suppression in normal males and males with 1° hypogonadism: evaluation of four androgens. Int J Androl 1978; (suppl 2, part 2 ): 720–729.Google Scholar
  102. 102.
    Nankin HR. Hormone kinetics after intramuscular testosterone cypionate. Fertil Steril 1987; 47: 1004–1009.PubMedGoogle Scholar
  103. 103.
    Sokal RZ, Palacios A, Campfield LA, et al. Comparison of the kinetics of injectable testosterone in eugonadal and hypogonadal men. Fertil Steril 1982; 37: 425–430.Google Scholar
  104. 104.
    Snyder PJ, Lawrence DA. Treatment of male hypogonadism with testosterone enanthate. J Clin Endocrinol Metab 1980; 51: 1335–1339.PubMedCrossRefGoogle Scholar
  105. 105.
    Handelsman DJ, Conway AJ, Boylan LM. Pharmacokinetics and pharmacodynamics of testosterone pellets in man. J Clin Endocrinol Metab 1990; 71: 216–222.PubMedCrossRefGoogle Scholar
  106. 106.
    Behre HM, Nieschlag E. Testosterone bucilate (20-Aet-l) in hypogonadal men: pharmacokinetics and pharmacodynamics of the new long-acting androgen ester. J Clin Endocrinol Metab 1992; 75: 1204–1210.PubMedCrossRefGoogle Scholar
  107. 107.
    Burris AS, Ewing LL, Sherins RJ. Initial trial of slow-release testosterone microspheres in hypogonadal men. Fertil Steril 1988; 50: 493–497.PubMedGoogle Scholar
  108. 108.
    Bhasin S, Swerdloff RS, Steiner B, et al. A biodegradable testosterone microcapsule formulation provides uniform eugonadal levels of testosterone for 10–11 weeks in hypogonadal men. J Clin Endocrinol Metab 1992; 74: 75–83.PubMedCrossRefGoogle Scholar
  109. 109.
    Stuenkel CA, Dudley RE, Yen SSC. Sublingual administration of testosterone-hydroxylpropyl-ß-cyclodextrin inclusion complex stimulates episodic androgen release in hypogonadal men. J Clin Endocrinol Metab 1991; 72: 1054–1059.PubMedCrossRefGoogle Scholar
  110. 110.
    Salehian B, Wang C, Alexander G. Pharmacokinetics, bioefficacy, and safety of sublingual testosterone cyclodextrin in hypogonadal men: comparison to testosterone enanthate—a clinical research center study. J Clin Endocrinol Metab 1995; 80: 3567–3575.PubMedCrossRefGoogle Scholar
  111. 111.
    Partsch C-J, Weinbauer GF, Fang R, Nieschlag E. Injectable testosterone undecanoate has more favourable pharmacokinetics and pharmacodynamics than testosterone enanthate. Eur J Endocrinol 1995; 132: 514–519.PubMedCrossRefGoogle Scholar
  112. 112.
    Sundarin K, Kumar N, Bardin CW. 7 alpha-methyl-19-nortestosterone: an ideal androgen for replacement therapy. Recent Prog Horm Res 1994; 49: 373–376.Google Scholar
  113. 113.
    Richman RA, Kirsh LR. Testosterone treatment in adolescent boys with constitutional delay in growth and development. N Engl J Med 1988; 319: 1563–1567.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1997

Authors and Affiliations

  • Glenn R. Cunningham
  • Max Hirshkowitz

There are no affiliations available

Personalised recommendations