Dr. Gary Wittert concurred.
"It’s extremely motivating to men to see their testosterone level come up to normal and the associated improvement in body weight, erectile dysfunction, and the significant improvement in lower urinary tract symptoms. So the message is quite clear: If you can’t motivate men to deal with their subclinical coronary artery disease, they will definitely be motivated to deal with their erections and their frequent night urination," declared Dr. Wittert, professor of medicine at the University of Adelaide, Australia, who is a testosterone clinical trialist not involved in these studies.
Dr. Saad noted that another attribute of testosterone normalization that may be highly relevant to progressive long-term weight loss is that testosterone increases fat-free mass. He cited a recent pilot study in which hypogonadal men with spinal cord injury received transdermal testosterone replacement. In 1 year, their fat-free mass increased by an average of 3.5 kg and their resting energy expenditure rose by 112 kcal/day (Horm. Metab. Res. 2011;43:574-9).
"If you accumulate that over 5 years, it could be a major contributor to the weight loss the men in our study experienced," Dr. Saad observed.
Dr. Vineeth Mohan, who chaired a session where Dr. Saad presented his findings, said the new data raise the possibility that a large weight loss in a patient treated for male hypogonadism could be an indicator that natural testosterone production has recovered and replacement therapy is no longer needed. That would make sense, since adipose tissue is a powerful suppressor of testosterone production.
"I might look at that loss of a significant amount of body weight as a signal that the testosterone axis has improved, and perhaps as an opportunity for reassessment," said Dr. Mohan, an endocrinologist at the Cleveland Clinic Foundation in Weston, Fla.
He reported having no financial conflicts.