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Related Experiment Videos

Experience with transdermal testosterone replacement therapy for hypogonadal men.

S Parker1, M Armitage

  • 1Diabetes and Endocrine Unit, Royal Bournemouth Hospital, UK.

Clinical Endocrinology
|May 26, 1999
PubMed
Summary

Transdermal testosterone replacement therapy (TRT) showed potential but suffered from low patient acceptance due to side effects. Most hypogonadal men preferred other TRT methods despite its physiological advantages.

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Area of Science:

  • Endocrinology
  • Andrology
  • Pharmacology

Background:

  • Existing long-term testosterone replacement therapies (TRT) for hypogonadal men have limitations, including invasiveness, inconvenience, and suboptimal hormone levels.
  • Oral TRT often leads to poor hormone levels and undesirable metabolic changes.
  • Transdermal formulations offer a potential therapeutic advancement for testosterone replacement.

Purpose of the Study:

  • To conduct a clinical audit of the first available transdermal testosterone therapy in the UK (Andropatch).
  • To compare the acceptability and efficacy of transdermal TRT against existing androgen replacement options in hypogonadal men.

Main Methods:

  • A cohort of 50 hypogonadal men undergoing long-term TRT was studied.
  • Data collected included serum testosterone levels and patient questionnaires on efficacy, side effects, therapy preference, sexual dysfunction, and partner attitudes.

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  • Analysis compared outcomes of transdermal therapy with depot and oral testosterone replacement.

    • Main Results:

    • Eighty-four percent of men experienced adverse effects with transdermal therapy, primarily dermatological issues.
    • Only 22% chose to continue transdermal therapy, with 72% returning to depot and 5% to oral therapy.
    • While testosterone levels were comparable to depot therapy with a better pharmacokinetic profile, patient acceptability was low due to patch discomfort and size.

    Conclusions:

    • Adverse event rates for transdermal TRT were higher than in clinical trials, aligning with safety reports.
    • The pharmacokinetic advantages of transdermal therapy were outweighed by poor patient acceptability.
    • In its current form, transdermal testosterone replacement is an expensive option, mainly suitable for patients intolerant to depot testosterone.