Testosterone supplements connected to adverse CV events

Use of testosterone gel in older men with limited mobility and high rates of chronic illness resulted in higher risk of negative cardiovascular events, according to results of a recent study.

Researchers from several institutions evaluated 209 men age 65 years and older (mean age, 74) who had reduced mobility and a total serum testosterone level of 100 to 350 ng/dL or free serum testosterone level of

The trial, led by Shalender Bhasin, MD, of Boston University School of Medicine, was halted early due to a higher rate of cardiovascular events in the testosterone group than in the placebo group. During the study period, those taking testosterone had higher rates of cardiac, respiratory, and dermatologic side effects than did the placebo group. In the testosterone group, 23 men experienced cardiovascular-related events, compared with five in the placebo group. Compared to those taking placebo, the testosterone group experienced markedly better improvements in leg-press and chest-press strength and in stair climbing while carrying a load, Dr. Bhasin and colleagues reported online in the New England Journal of Medicine (June 30, 2010).

In related news, researchers have detected certain physical and psychological symptoms that, coupled with a lower testosterone level, can help pinpoint "male menopause."

Study researchers from the University of Manchester, England, working with several other institutions, note that about 2% of older men enrolled in the European Male Aging Study may have male menopause. Findings came from a random sampling of 3,369 men in the European Male Aging Study (age range, 40-79 years). Men were surveyed about their physical, sexual, and psychological health. Morning blood samples were collected to assess testosterone levels.

First author Frederick C. W. Wu, MD, of the University of Manchester and colleagues noted three symptoms related to sexual health that were tied to a lower testosterone level and assisted in a male menopause diagnosis: erectile dysfunction, reduced sex drive, and less frequency of morning erection. Some non-sexual symptoms were recognized as possibly aiding in a male menopause diagnosis. Three physical symptoms were challenges with participating in vigorous physical activity, inability to walk a short distance, and being unable to bend or stoop. Three psychological symptoms were low energy, feeling sad, and fatigue. The physical and psychological symptoms were not as strongly associated to low testosterone levels as the sexual symptoms.

The findings, which were published online in the New England Journal of Medicine (June 16, 2010), may help better determine who may be able to use testosterone-replacement therapy, Dr. Wu said.

Dr. Wu and his team noted that the differences in testosterone levels between men with symptoms and men without symptoms "were marginal, highlighting the weak overall association between symptoms and testosterone levels." Researchers made note that the data collection about the patient symptoms was based on patients’ recall, which may reflect bias.