Conclusions Oral TRT produces significant CV risk .
Differences in the degree to which serum DHT is elevated may underlie the varying CV risk by TRT administration route , as elevated serum dihydrotestosterone has been shown to be associated with CV risk in observational studies
Background Potential cardiovascular ( CV ) risks of testosterone replacement therapy ( TRT ) are currently a topic of intense interest .
However , no studies have addressed CV risk as a function of the route of administration of TRT .
Effect of chronic oral testosterone undecanoate administration on the pituitary-testicular axes of hemodialyzed male patients.
Testosterone undecanoate ( TU ) or placebo was administered orally ( for 12 weeks ) in a double blind study , to 19 patients with chronic renal insufficiency on hemodialysis in a daily dose of 240 mg . Effect on plasma testosterone ( T ) , dihydrotestosterone ( DHT ) , and rostenedione ( A ) , 110H and rostenedione ( 110A ) , FSH , LH and PRL concentration and the pituitary responsiveness to LH-RH/TRH stimulation was studied . These hormone levels were determined before the study and after 6 and 12 weeks of treatment . There was a rise in plasma and rogen concentration in all treated patients . Mean plasma DHT , A and 110A increased at 12 weeks from 0.3 , 0.85 and 1.13 ng/ml to 1.13 ( p less than 0.05 ) , 1.4 ( p less than 0.05 ) and 1.44 ( p less than 0.05 ) respectively . There was no change in plasma T or free testosterone . However , basal LH , FSH fell progressively from 5.51 and 5.51 ng/ml to 2.13 and 1.84 ng/ml ( p less than 0.05 ) . The level of significance of these changes was confirmed when the response to LH-RH was considered . Basal plasma PRL also decreased from 376 microU/nl to 306 ( p less than 0.05 ) , but PRL response to TRH remained unchanged . In contrast , none of these modifications were observed in placebo-treated patients . We conclude that oral TU restored to normal the pituitary-testicular axis . This form of treatment should be preferentially chosen instead of intramuscular injections in these frequently heparinized patients on hemodialysis
Conclusions Oral TRT produces significant CV risk .
Differences in the degree to which serum DHT is elevated may underlie the varying CV risk by TRT administration route , as elevated serum dihydrotestosterone has been shown to be associated with CV risk in observational studies
Background Potential cardiovascular ( CV ) risks of testosterone replacement therapy ( TRT ) are currently a topic of intense interest .
However , no studies have addressed CV risk as a function of the route of administration of TRT .