SEATTLE — Low-testosterone problems are not as rare as you might think. That's because they are associated with two common problems: erectile dysfunction and metabolic syndrome, Dr. Richard F. Spark said at the annual meeting of the American Association of Clinical Endocrinologists.
“Some new developments indicate that there are a lot more patients with hypogonadism in your practice than we have been aware of,” said Dr. Spark, an endocrinologist at Beth Israel Deaconess Medical Center, Boston.
Dr. Spark said that one of the first reports that erectile dysfunction could be associated with low testosterone was his own, published in 1980. He measured serum testosterone in 105 consecutive patients who were seen for what was then called impotence. They found that 20 of those individuals had low serum testosterone, and when they were treated for that, their erectile dysfunction went away (JAMA 1980;243:750–5).
In 2000, a meta-analysis of studies of testosterone replacement suggested that 57% of patients with erectile dysfunction treated with testosterone had resolution of their problem, including 64% of those with primary hypogonadism (J. Urol. 2000;164:371–5).
Testosterone has gotten a bad rap because of all of the press about athletes who abuse anabolic steroids, and because the controversies regarding hormone therapy for women have made people wary of hormone replacement, Dr. Spark said.
Low testosterone has also been associated with type 2 diabetes and metabolic syndrome, he continued.
In a study of 103 men with type 2 diabetes, 33% were found to have low testosterone levels, and they found low testosterone in all the age groups in the study (J. Clin. Endocrinol. Metab. 2004;89:5462–8).
“The message here is to check testosterone in metabolic syndrome patients and look for metabolic syndrome in low-testosterone patients,” Dr. Spark said.