Human Chorionic Gonadotropin monotherapy for the treatment of hypogonadal symptoms in men with total testosterone > 300 ng/dL

Vol. 45 (5): 1008-1012, September – October, 2019

doi: 10.1590/S1677-5538.IBJU.2019.0132


ORIGINAL ARTICLE

Vinayak Madhusoodanan 1, Premal Patel 2, Thiago Fernandes Negris Lima 2, Jabez Gondokusumo 3, Eric Lo 3, Nannan Thirumavalavan 3, Larry I. Lipshultz 3, Ranjith Ramasamy 2
1 University of Miami Miller School of Medicine, Miami, FL, USA; 2 Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA; 3 Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA

ABSTRACT

Purpose: The 2018 American Urological Association guidelines on the Evaluation and Management of Testosterone Defi ciency recommended that 300 ng/dL be used as the threshold for prescribing testosterone replacement therapy (TRT). However, it is not un- common for men to present with signs and symptoms of testosterone defi ciency, despite having testosterone levels greater than 300 ng/dL. There exists scant literature regarding the use of hCG monotherapy for the treatment of hypogonadism in men not interested in fertility. We sought to evaluate serum testosterone response and duration of therapy of hCG monotherapy for men with symptoms of hypogonadism, but total testosterone levels > 300 ng/dL. Materials and Methods: We performed a multi-institutional retrospective case series of men receiving hCG monotherapy for symptomatic hypogonadism. We evaluated patient age, treatment indication, hCG dosage, past medical history, physical exam fi ndings and serum testosterone and gonadotropins before and after therapy. Descriptive analysis was performed and Mann Whitney U Test was utilized for statistical analysis. Results: Of the 20 men included in the study, treatment indications included low libido (45%), lack of energy (50%), and erectile dysfunction (45%). Mean testosterone improved by 49.9% from a baseline of 362 ng/dL (SD 158) to 519.8 ng/dL (SD 265.6), (p=0.006). Median duration of therapy was 8 months (SD 5 months). Fifty percent of patients reported symptom improvement. Conclusions: Treatment of hypogonadal symptoms with hCG for men who have a baseline testosterone level > 300 ng/dL appears to be safe and effi cacious with no adverse events.

Keywords: Testosterone; Chorionic Gonadotropin; Hypogonadism

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