They change the criteria for measuring testosterone. A new tool called Trace (Testosterone ReplACEment) has been developed for the first time by specialists from the Italian Society of Andrology (Sia) – described in a new Sia study published in the Journal of Personalized Medicine – which helps doctors diagnose testosterone deficiency and prescribe hormone replacement therapy more precisely and appropriately. In fact, to determine whether to give testosterone therapy to older men with some symptoms of deficiency, it is not enough to simply evaluate hormone levels in the blood.
Symptoms
In addition to the laboratory parameterswhich include the values of Lh, luteinizing hormone, and Fsh, follicle-stimulating hormone, It is necessary to take into account a series of clinical signs and symptoms that highlight a testosterone deficiency, such as overweight and even obesity, hypertension, hyperglycemia, erectile dysfunction, depression, reduction in muscle mass, mood swings and decreased libido. If some or all of these symptoms are present, testosterone therapy or its derivatives are justified, even if laboratory levels are normal. To help doctors navigate so many factors, Sia specialists have created a new tool that can identify very precisely which patients will benefit from hormone treatment. In fact, there is a range of total testosterone values that is defined as a ‘gray zone’ in which it is not clear whether it is necessary to treat with replacement therapy or not, which therefore determines uncertainty and a possible significant therapeutic delay.
“Testosterone is the male hormone responsible for sexual function and the development of male sexual characteristics, i.e. development of muscle mass, pubic hair and tone of voice”, explains Alessandro Palmieri, president of Sia and professor of Urology at the Federico II University of Naples. In recent years, however, much attention has been paid to the role of this hormone in other aspects of male health. Testosterone deficiency is associated with significant cardiovascular and stroke risk, as well as a higher probability of developing osteoporosis. All very important pathologies for the quality of life of men. Furthermore, it has been shown that an early diagnosis of testosterone deficiency and an equally early appropriate therapy are able to significantly improve the state of health”.
The Trace Tool
Trace “is a graphic tool that integrates the testosterone levels calculated in laboratories with a series of parameters relating to symptoms and clinical conditions, each of which is assigned a score whose sum corresponds to a percentage of probability that the patient with testosterone deficiency requires treatment with hormone replacement therapy”, explains Tommaso Cai, national secretary of Sia and coordinator of the study. Through the statistical analysis performed for the Sia study, which confirmed the efficacy of Trace, the parameters with the greatest impact on the possibility of predicting hormone replacement therapy were selected.
“Among these – explains Cai – an important parameter is nocturnal erections, the absence of which is linked, among other things, to a possible testosterone deficiency or a lack of efficacy of the same. In fact, very often there may be normal levels of testosterone but this, for specific problems, is not able to have an effect on the target organs. Therefore, having a parameter available that can be an indirect demonstration of a deficit in efficacy is very important”.
“Much importance – he continues – is also attributed to some indices of metabolic problems, such as diabetes, obesity and hypertension. These parameters, if altered, also have an impact not only on the function of testosterone but also increase the risk of significant vascular disorders, including erectile dysfunction”. The nomogram also gives importance to indirect laboratory parameters such as Lh and Fsh. “These are two hormones that are produced by a small gland located at the base of the brain and are modified according to a biochemical or functional alteration of testosterone”, states Palmieri. The novelty compared to previous experiences is the evaluation of urinary symptoms. “Our analysis has shown how a testosterone deficit can also manifest itself with urinary disorders that are often underestimated”, points out Fabrizio Palumbo, president of the Sia Scientific Commission.
#Testosterone #criteria #measuring #change #method
