The effect of testosterone supplementation on BMD and the risk of falls or fracture remains inconclusive .
However , supplementation may benefit patients in the areas of sexual function and quality of life without increasing the risk of cardiovascular events , all-cause mortality , or prostatic events .
Testosterone deficiency ( TD ) may induce a series of clinical symptoms .
Studies have shown that testosterone supplementation may prevent these unfavourable symptoms and improve patients ’ quality of life .
Given the conflicting findings across studies , this systematic review aims to evaluate the effects and risks associated with testosterone supplementation in middle-aged or aging males with TD .
Is the haematopoietic effect of testosterone mediated by erythropoietin? The results of a clinical trial in older men
The stimulatory effects of testosterone on erythropoiesis are very well known , but the mechanisms underlying the erythropoietic action of testosterone are still poorly understood , although erythropoietin has long been considered a potential mediator . A total of 108 healthy men > 65 years old with serum testosterone concentration < 475 ng/dL were recruited by direct mailings to alumni of the University of Pennsylvania and Temple University , and r and omized to receive a 60‐cm2 testosterone or placebo patch for 36 months . Ninety‐six subjects completed the trial . We used information and stored serum specimens from this trial to test the hypothesis that increasing testosterone increases haemoglobin by stimulating erythropoietin production . We used information of 67 men , 43 in the testosterone group and 24 in the placebo group who had banked specimens available for assays of testosterone , haemoglobin and erythropoietin at baseline and after 36 months . The original r and omized clinical study was primarily design ed to verify the effects of testosterone on bone mineral density . The primary outcome of this report was to investigate whether or not transdermal testosterone increases haemoglobin by increasing erythropoietin levels . The mean age ± SD of the 67 subjects at baseline was 71.8 ± 4.9 years . Testosterone replacement therapy for 36 months , as compared with placebo , induced a significant increase in haemoglobin ( 0.86 ± 0.31 g/dL , p = 0.01 ) , but no change in erythropoietin levels ( −0.24 ± 2.16 mIU/mL , p = 0.91 ) . Included time‐varying measure of erythropoietin did not significantly account for the effect of testosterone on haemoglobin ( Treatment‐by‐time : β = 0.93 , SE = 0.33 , p = 0.01 ) . No serious adverse effect  was observed . Transdermal testosterone treatment of older men for 36 months significantly increased haemoglobin , but not erythropoietin levels . The haematopoietic effect of testosterone does not appear to be mediated by stimulation of erythropoietin production
The effect of testosterone supplementation on BMD and the risk of falls or fracture remains inconclusive .
However , supplementation may benefit patients in the areas of sexual function and quality of life without increasing the risk of cardiovascular events , all-cause mortality , or prostatic events .
Testosterone deficiency ( TD ) may induce a series of clinical symptoms .
Studies have shown that testosterone supplementation may prevent these unfavourable symptoms and improve patients ’ quality of life .
Given the conflicting findings across studies , this systematic review aims to evaluate the effects and risks associated with testosterone supplementation in middle-aged or aging males with TD .