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 .
Substitution therapy of hypogonadal men with transdermal testosterone over one year.
Current testosterone substitution therapy either by injectable or oral testosterone esters suffers from markedly fluctuating serum testosterone levels often far above or below the physiological range . Recently , a transdermal therapeutic system ( TTS ) for the delivery of testosterone was developed which , when applied to the scrotum , provides smooth serum testosterone levels . Here we report results from seven hypogonadal men treated with the TTS for 14 months by applying a new patch every day . In all patients serum testosterone and dihydrotestosterone ( DHT ) determined 3 - 5 h after applying a new patch increased significantly and remained within the physiological range during the entire treatment period . The DHT/testosterone ratio remained constant . In 4 of these patients and 2 others under TTS treatment serum testosterone and DHT were also determined over a 24-h period at regular intervals . In these patients serum testosterone levels in the physiological range were seen during the entire observation period , whereas an increase in the DHT/testosterone ratio occurred towards the end of the one-day treatment phase . All patients in the 14-month treatment study were clinical ly well substituted and responded with good compliance . Clinical chemistry showed no abnormalities during treatment . Thus , the TTS appears to be an effective and safe new modality for the treatment of male hypogonadism
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 .