October 2010
Effects of testosterone supplementation on depressive symptoms and sexual dysfunction in hypogonadal men with the metabolic syndrome.Giltay EJ, Tishova YA, Mskhalaya GJ, et al. J Sex Med. 2010 Jul;7(7):2572-82.
KEY POINTS
The Russian study looked at 184 men with metabolic syndrome (Met S) and hypogonadism. This was a double-blind, placebo-controlled study of Nebido 1000mg vs placebo.1 The baseline testosterone (T) for this 30 week study was 8.0 nmol/l.1 The mean baseline BMI was 35.5 kg/m21 with a reduction of 1.32 occurring in the treatment group and no change with placebo.1
The baseline BDI depression score improved by 2.5 (p=0.003), AMS scale by 7.4 (p<0.001) and IIEF-5 by 3.1 (P<0.001).1The strongest effect was seen in men with lowest baseline T levels.1
Depression is common in type 2 diabetes and metabolic syndrome. Over 60% of the men in this study of hypogonadal men suffered from severe or moderate depression, much higher than the general population.
Detecting and treating depression in the diabetic population is a health priority but routine measurement of testosterone is not. Testosterone supplementation has been shown to have additive benefit to antidepressant therapy in a number of small studies.1
This study suggests that depression in obese men with metabolic syndrome is strongly linked with hypogonadism and that testosterone supplementation alone may improve depression in these patients.1 The improvement in AMS scale and IIEF were similar to changes seen in other studies.1
The reduction in BMI after only 30 weeks is similar to other studies2 and would equate to a reduction in cardiovascular risk in hypogonadal men.3 In view of the improvement seen between 18 and 30 weeks, it would be interesting to see if improvements continued for one year and beyond.
This well conducted Russian study showed strong links between low testosterone and depression in overweight men with greatly increased health risks. Treatment with testosterone improved depression, wellbeing and sexual function1 as well as reducing weight.1
There were no health concerns associated with testosterone therapy.1