Late-onset hypogonadism: the advantages of treatment with human chorionic gonadotropin rather than testosterone

Aging Male. 2016;19(1):34-9. doi: 10.3109/13685538.2015.1092021. Epub 2015 Oct 21.

Abstract

The traditional pharmacological treatment of patients with late onset hypogonadism (LOH) is represented by different formulations of testosterone (T) or alternatively by the extractive human chorionic gonadotropin (HCG). The hormone replacement treatment (HRT) is associated with the potential increase of hematocrit, serum concentrations of prostate-specific antigen (PSA) and prostate volume. Moreover, the gynecomastia represent a condition frequently associated with HRT. Recent evidences showed the role of leydig cells in the 25-hydroxylation of vitamin D and the elevated frequency of hypovitaminosis D among LOH patients. Finally, another important aspect of LOH is represented by the frequency of secondary infertility due to age or to traditional HRT. This study evaluated 40 LOH patients treated for 6 months with extractive HCG (n = 10 patients) and three different formulations of T: transdermal (n = 10 patients), undecaonate (n = 10 patients) and enantate (n = 10 patients). Hormonal, anthropometric, metabolic and sperm parameters were evaluated and compared. Moreover, the main safety parameters and the results of the main questionnaires were evaluated. After treatment, HCG group showed serum concentrations of 25-OH-vitamin D significantly higher (p < 0.05) and serum concentrations of oestrogens significantly lower (p < 0.05) compared with other groups. Moreover, they showed a mean value of hematocrit, PSA and prostate volume significantly lower (p < 0.05) compared with other groups. Finally, all the groups treated with T showed a significant reduction (p < 0.05) of sperm density and of percentage of spermatozoa with progressive motility compared with HCG group.

Keywords: Human chorionic gonadotropin; late onset hypogonadism; testosterone.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Cutaneous
  • Chorionic Gonadotropin / adverse effects
  • Chorionic Gonadotropin / therapeutic use*
  • Drug Administration Schedule
  • Hematocrit
  • Hormone Replacement Therapy / adverse effects
  • Hormone Replacement Therapy / methods
  • Humans
  • Hypogonadism / complications
  • Hypogonadism / drug therapy*
  • Injections, Intramuscular
  • Male
  • Middle Aged
  • Prostate / drug effects
  • Prostate-Specific Antigen / blood
  • Surveys and Questionnaires
  • Testosterone / adverse effects
  • Testosterone / therapeutic use*
  • Vitamin D / blood
  • Vitamin D Deficiency / etiology

Substances

  • Chorionic Gonadotropin
  • Vitamin D
  • Testosterone
  • Prostate-Specific Antigen