Testosterone levels among men with spinal cord injury: relationship between time since injury and laboratory values

The objectives of the present study were to determine the prevalence of low testosterone among a sample of men with spinal cord injury and to examine the relationship among testosterone, time since injury, and select laboratory values.

Participants were 102 men with spinal cord injury participating in inpatient or outpatient rehabilitation. Data included total serum testosterone level, demographic and injury information, and laboratory values.

Sixty percent of men with spinal cord injury had low testosterone levels. The median testosterone level for the entire sample was 220 ng/dl (normal reference range = 241-827 ng/dl). Low testosterone was significantly associated with less time since injury, lower hemoglobin, and higher prolactin in the univariate analyses at P < 0.05.

The results indicate that men with spinal cord injury are at risk for low serum testosterone. Testosterone levels were also related to time since injury and hemoglobin and prolactin levels. These findings suggest the need for changes to occur in clinical practice. Guidelines are needed for when and how often testosterone monitoring should be conducted. Future research should address the pathophysiology of low testosterone and the outcomes of testosterone treatment.