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 .
Transdermal testosterone gel increases serum testosterone levels in hypogonadal men in Taiwan with improvements in sexual function
A r and omized , double-blind , placebo-controlled trial was conducted to ( 1 ) evaluate efficacy and safety of transdermal testosterone gel ( And roGel )  for hypogonadal men in Taiwan , and ( 2 ) observe improvements in sexual function through international index of erectile function ( IIEF ) scores . Eligible hypogonadal men were r and omized to receive 50 mg/day transdermal testosterone gel ( TTG ) or placebo for 3 months . Primary end point was change from baseline in total testosterone ( TT ) and free testosterone ( FT ) . Secondary end points were change from baseline in serum hormone levels ( such as dihydrotestosterone ( DHT ) , estradiol ( E2 ) , luteinizing hormone ( LH ) , follicle-stimulating hormone ( FSH ) and sex-hormone-binding globulin ( SHBG ) ) and changes in IIEF scores . Safety evaluations included adverse events ( AEs ) and skin irritation assessment . Compared with baseline , the  TTG  group ( n=20 ) had statistically significant increases in mean TT levels at month 1 ( P=0.024 ) and month 2 ( P=0.025 ) , but no significant changes at month 3 . TT levels in the placebo group ( n=18 ) showed no statistically significant change at any visit . Changes in FT levels paralleled changes in TT levels in both groups . TTG group IIEF scores were significantly increased at month 3 ( P=0.01 ) , compared with a decline in placebo scores . No drug-related AEs occurred in the TTG group ; the placebo group had 2 AEs ( mild skin rash ) . In conclusion , TTG effectively restores serum TT and FT levels to a normal physiological range for hypogonadal men in Taiwan and improves sexual function
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 .