Long-term testosterone replacement therapy reduces fatigue in men with hypogonadism

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Background: Testosterone replacement therapy (TRT) is one of the main lines of treatment for men with hypogonadism. This study sought to evaluate the influence of TRT in men with late-onset hypogonadism (LOH), regarding fatigue, coronary artery disease (CAD), carotid intima-media thickness (CIMT) and cardiovascular risk.

Methods: This study compared men with LOH already on TRT for >1 year to newly diagnosed men with LOH who recently started TRT (controls). We included men aged >18 years with clinical manifestations of testosterone deficiency and testosterone levels of <300 ng/dL documented in two separate occasions.

Results: A total of 33 patients were included in the study group and 30 in the control group. Mean age was 49.1 years (±11.5) in those already under TRT for >1 year and 45 (±12.2) years in the control group (p=0.18). CAD was present in 14 (46.7%) patients in the control group and in 3 (9.1%) in the study group (p<0.001). TRT >1 year was not associated with lower rates of CAD in multivariable analysis. Fatigue Severity Score was significantly higher in the control group (39.2±15.0), compared to TRT >1 year (23.5±8.1; p<0.001). In a multivariable analysis adjusted for age and hypertension, TRT >1 year was associated with a 14.8-point decrease in Fatigue Severity Score (p<0.001). Overall, there were no differences between the study group and the control group regarding cardiovascular risk (p=0.31).

Conclusion: TRT for >1 year was associated with significantly lower fatigue scores. No differences were observed regarding CIMT, CAD and cardiovascular risk according to the WHO-ISH scale.

Keywords: fatigue, heart disease risk factors, hypogonadism, testosterone.

Citation: de Almeida Ferreira M, Mendonça JA. Long-term testosterone replacement therapy reduces fatigue in men with hypogonadism. Drugs Context. 2022;11:2021-8-12. https://doi.org/10.7573/dic.2021-8-12

Contributions: MF: conceptualization, data curation, statistical analysis, writing of original draft; JAM: conceptualization, methodology, writing, review, and supervision. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: The authors declare that they have no conflicts of interest relevant to this manuscript. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2022/01/dic.2021-8-12-COI.pdf

Acknowledgements: None.

Funding declaration: There was no funding associated with the preparation of this article.

Copyright: Copyright © 2022 de Almeida Ferreira M, Mendonça JA. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2022 de Almeida Ferreira M, Mendonça JA. https://doi.org/10.7573/dic.2021-8-12. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://www.drugsincontext.com/long-term-testosterone-replacement-therapy-reduces-fatigue-in-men-with-hypogonadism

Correspondence: José Alexandre Mendonça, Rua da Fazenda 125, Sumaré, Brazil. Email: mendoncaja.us@gmail.com

Provenance: Submitted; externally peer reviewed.

Submitted: 29 August 2021; Accepted: 10 December 2021; Publication date: 2 February 2022.

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