Long-term treatment of hypogonadal men with intramuscular testosterone undecanoate: An interdisciplinary view


Long-term treatment of hypogonadal men with intra-muscular testosterone undecanoate – an interdisciplinary view

Dr. Zitzmann presents the issue of hypogonadism, emphasizing the link between obesity and diabetes with hypogonadism. He welcomes the new 2012 EAU guidelines for initiation of testosterone therapy, and their acknowledgement that metabolic derangement is already a symptom of hypogonadism. In addition, compensated hypogonadism (elevated LH in the presence of normal T levels) or insensitive androgen receptors (AR gene CAG-repeats >25) may be considered potential markers of hypogonadism.

Dr. Zitzmann underscores the deleterious effects of expanded waist circumference (a surrogate marker of visceral fat) for Leydig cell function, and the vicious circle between abdominal obesity and hypogonadism. As he explains, it does not matter where a man enters the vicious circle - if he first presents with elevated visceral fat or hypogonadism - because these factors both (independently) reinforce the vicious cycle.

He also points out that it may take 3 years or more for achievement of the full spectrum of health improvements with testosterone therapy, especially when treating obese patients. In contrast to the U-shaped curve for weight loss seen with traditional obesity treatments, which are characterized by weight loss and weight regain, treatment with testosterone therapy results in a continuous reduction in obesity parameters (waist circumference, weight and BMI) for >5 years.


Professor Michael Zitzmann, born in 1964, teaches endocrinology (hormone disorders) and andrology (male health care) at the University Hospital of Muenster, Germany. He is involved in specialised patient care, ranging from boys with pubertal disorders to older men with a variety of sexual and metabolic problems. Couples with fertility problems form a major part of the patient clientele, as well as men with chronic inherited hormone disorders requiring life-time attention.

Michael Zitzmann is largely involved in the research of the interplay of genetic issues, hormones, psychological characteristics and obesity. He also cooperates with Prof. Bettina Pfleiderer in the BMBF funded research project “Gender-sensitive Concepts in Neuroscience“. He has received several international awards and grants in recognition of his work and is a member of international committees as well as journal editorial boards.

From: http://www.asiaandro.com/Editor/Michael_Zitzmann.asp



Prof. Dr. Michael Zitzmann

Prof. Dr. Michael Zitzmann
Fellow of the Royal Society of Medicine
Andrologist, Endocrinologist, Diabetologist
Specialist for Sexual Medicine (FECSM)
Centre for Reproductive Medicine and Andrology
University Clinics, Muenster, Germany

Related Videos