The Nebido® Treatment Tracker is a tool designed to help HCPs improve patient adherence to Nebido treatment. The British Society for Sexual Medicine (BSSM) guideline recommends initiating testosterone therapy only in conjunction with weight-loss advice and lifestyle modification. Considering that lifestyle change is notoriously difficult for patients to achieve and maintain, and the need for long-term adherence to Nebido® treatment in order to achieve the full spectrum of health benefits, the Nebido® Treatment Tracker was developed.
The “Testosterone 4 Diabetes Mellitus” study, also known as the T4DM trial, is a large study designed to find out if testosterone therapy combined with lifestyle intervention (Weight Watchers®) for 2 years vs. lifestyle intervention alone, improves glucose tolerance and reduces incidence of type 2 diabetes.
The T4DM trial will be the first ever study to specifically investigate the effects of testosterone therapy on motivation and telomere length, a biomarker of aging.
Does it matter which testosterone preparation is prescribed for testosterone therapy? This is a common question among HCPs as well as patients. A new meta-analysis shows that testosterone therapy with injectable testosterone preparations results in larger muscle and strength gains compared to transdermal testosterone preparations. This has important implications for the growing population of men with hypogonadism, who are at high risk of lean (muscle) mass loss, obesity, diabetes and sarcopenia.
The Testosterone Trials show that testosterone therapy confers significant and clinically meaningful health benefits in older men with low testosterone levels. Even though the Testosterone Trials aimed to recruit men with hypogonadism due to no apparent reason other than age, in fact the majority of enrolled men were obese and more than one third had type 2 diabetes. Obesity, metabolic syndrome and/or type 2 diabetes are stronger risk factors for hypogonadism than aging per se.
A long-held belief is that high testosterone levels increase risk of prostate cancer. To the contrary, most studies show that it is low testosterone that increases risk of prostate cancer. Furthermore, emerging data – summarized here - suggest that it may not be the absolute level of testosterone that predicts prostate cancer development, but rather patterns of change in testosterone levels, such as steep declines with age or reductions in testosterone at younger age.
Hypogonadism (testosterone deficiency) is more common than previously thought, even in younger men. Men with hypogonadism – regardless of age – have a higher prevalence of muscle weakness and simultaneous occurrence of several risk factors and chronic diseases.
Low bone mineral density is a prevalent and treatable cause of osteoporosis and its associated morbidity and mortality in men with hypogonadism. The Bone Trial of the Testosterone Trials - a series of the largest studies to date on the effects of testosterone therapy in hypogonadal men - unequivocally showed that testosterone therapy significantly increases bone mineral density and estimated bone strength. This would be expected to reduce osteoporosis and fractures.
Clinical practice guidelines on hypogonadism and testosterone therapy aim to help clinicians diagnose and treat men who present with hypogonadism. However, due to lack of scientific data on several issues, guidelines recommendations inevitably contain an element of opinion, which is why there are contradictions between some recommendations issued by different guidelines.
The most widely known effect of testosterone therapy is improved sexual function. But testosterone therapy actually has a wide range of physiological effects in men, including increased muscle mass, decreased fat mass (both overall and belly fat), improved insulin sensitivity, reduced risk of the metabolic syndrome and type 2 diabetes, improved mood / depressive symptoms, energy, and quality of life, reduced lower urinary tract symptoms, and importantly, reduced risk of all-cause and cardiovascular mortality.
Pastuszak AW, Kohn TP, Estis J, Lipshultz LI. Low Plasma Testosterone Is Associated With Elevated Cardiovascular Disease Biomarkers. The journal of sexual medicine. 2017;14(9):1095-1103.
The fear of increased risk of heart attack and stroke with testosterone therapy was mainly caused by two high profile but flawed studies. Even though many new studies have refuted these alleged cardiovascular risks and even demonstrated that testosterone therapy is associated with a reduced cardiovascular risk, concern still remains.