TESTOSTERONE SUPPLEMENTATION FOR HYPOGONADAL IMPOTENCE - ASSESSMENT OF BIOCHEMICAL MEASURES AND THERAPEUTIC OUTCOMES

Purpose: Although hypogonadism is a rare cause of erectile failure, im potent men are frequently treated with supplemental androgens. The res ults of such treatment and the individual merits of available formulat ions remain controversial. A series of hypogonadal men participated in a trial of oral testosterone undecanoate to assess the effectiveness of the medication, and use of biochemical and clinical outcome measure s. Materials and Methods: A consecutive sample of 23 hypogonadal impot ent men received testosterone undecanoate orally for no less than 60 d ays. Serum levels of gonadotropins, testosterone,estrogens and sex hor mone-binding globulin were measured before, during and after the trial , Sexual response and feeling of well-being were measured by daily dia ries and visual analogue scales. Results: Testosterone undecanoate pro duced restoration of plasma testosterone levels in all patients but a measurable improvement in sexual attitudes and performance in only 61% . Visual analogue scores were effective discriminants of the therapeut ic response but none of the conventional biochemical measures predicte d or correlated with clinical outcome. Conclusions: Testosterone undec anoate is an effective agent for treating hypogonadism. In hypogonadal impotent patients the most appropriate outcome measure for androgen s upplementation is individual response to therapy, while conventional b iochemical hormone determinations lack predictive value and fail to co rrelate with response.