Testosterone improves depression and quality of life scores in hypogonadal men
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
- This is the first publication from The Moscow Study, a placebo-controlled study in men with metabolic syndrome with a total duration of three years. The first 30 weeks are placebo-controlled, then all men are switched to Nebido®
- All three questionnaires, the Beck Depression Inventory (BDI-IA), the Aging Males' Symptoms (AMS) scale, and the International Index of Erectile Function 5-item (IIEF-5) scale improved significantly in the testosterone group1
- These improvements persisted after correcting for smoking habits, BMI, and the presence or absence of type 2 diabetes1
- These improvements correlated with improvements in BMI. This means that patients felt better and functioned better when they lost weight, and the more weight they lost, the more they improved1
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
What is known
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
What this study adds
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.
Patient perspective
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
Recommendations
References
- "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. Return to content
- "Serum testosterone and bioavailable testosterone correlate with age and body size in hypogonadal men treated with testosterone undecanoate (1000 mg IM--Nebido)." Moisey R, Swinburne J, Orme S. Clin Endocrinol (Oxf).2008 Oct;69(4):642-7. Return to content
- "The dark side of testosterone deficiency: III. Cardiovascular Disease." Traish AM, Saad F, Feeley R, Guay A. J Androl. 2009 30(5):477-494. Return to content
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