The findings of the study described here confirm that treating older men with testosterone does not improve their cognitive functioning. The study did not suffer from the limitations of previous studies, which reported inconsistent outcomes. It used a sufficiently large study sample with constant baseline testosterone values, a stable, controlled double-blind treatment and sensitive, validated outcome measures. Obviously, the outcomes are not valid for other populations, such as men with normal serum testosterone values or men with severe androgen deficiency due to a testicular or pituitary disease. In most cases, long-term intended or unintended effects are unknown.
The JAMA commentator comments that global sales of testosterone have increased a hundredfold over the last decade, mostly because the definition of hypogonadism used in the USA has, for commercial reasons, come to include ‘any condition involving reduced serum testosterone levels’. The name andropause is blurring the fundamental distinction between pathological hypogonadism (a congenital or acquired organic reproductive disease) and functional changes like those naturally occurring with ageing. Androgel is currently used by 16,000 people in the Netherlands; its use has only marginally increased over the last five years.
- Bouma J, et al. NHG-Standaard Seksuele klachten (eerste herziening). Huisarts Wet 2015; 58: 586-597.
- Resnick SM, et al. Testosterone treatment and cognitive function in older men with low testosterone and age-associated memory impairment. JAMA 2017; 317: 717-727.
- Snyder PJ, et al. Effects of testosterone treatment in older men. N Engl J Med. 2016; 374: 611-624.
- Orwoll ES. Establishing a framework. Does testosterone supplementation help older men? N Engl J Med. 2016; 374: 682-683.
- NEJM 2016; 375 : 88-90.
- Via: http://www.consort-statement.org/
- Handelsman DJ. Testosterone and male aging: Faltering hope for rejuvenation. JAMA 2017; 317: 699-701.
- GIP databank van Zorginstituut Nederland.
*The literature refers to the Dutch text