Scientific Affairs Men's Healthcare, BU General Medicine/Men's Healthcare, Bayer Pharma AG, D-13342 Berlin, Germany.
Eur J Endocrinol. 2011 Nov;165(5):675-85. doi: 10.1530/EJE-11-0221. Epub 2011 Jul 13.
Testosterone has a spectrum of effects on the male organism. This review attempts to determine, from published studies, the time-course of the effects induced by testosterone replacement therapy from their first manifestation until maximum effects are attained.
Literature data on testosterone replacement.
Effects on sexual interest appear after 3 weeks plateauing at 6 weeks, with no further increments expected beyond. Changes in erections/ejaculations may require up to 6 months. Effects on quality of life manifest within 3-4 weeks, but maximum benefits take longer. Effects on depressive mood become detectable after 3-6 weeks with a maximum after 18-30 weeks. Effects on erythropoiesis are evident at 3 months, peaking at 9-12 months. Prostate-specific antigen and volume rise, marginally, plateauing at 12 months; further increase should be related to aging rather than therapy. Effects on lipids appear after 4 weeks, maximal after 6-12 months. Insulin sensitivity may improve within few days, but effects on glycemic control become evident only after 3-12 months. Changes in fat mass, lean body mass, and muscle strength occur within 12-16 weeks, stabilize at 6-12 months, but can marginally continue over years. Effects on inflammation occur within 3-12 weeks. Effects on bone are detectable already after 6 months while continuing at least for 3 years.
The time-course of the spectrum of effects of testosterone shows considerable variation, probably related to pharmacodynamics of the testosterone preparation. Genomic and non-genomic effects, androgen receptor polymorphism and intracellular steroid metabolism further contribute to such diversity.
睾酮对男性机体具有广泛的影响。本综述试图从已发表的研究中确定，从睾酮替代治疗首次表现到达到最大效果的时间过程中，其诱导的作用的时程。
关于睾酮替代的文献资料。
性兴趣的影响在 3 周后出现平台，6 周后达到峰值，之后不再增加。勃起/射精的变化可能需要长达 6 个月。生活质量的变化在 3-4 周内显现，但最大益处需要更长时间。抑郁情绪的影响在 3-6 周后可检测到，18-30 周后达到最大值。对红细胞生成的影响在 3 个月时明显，在 9-12 个月时达到峰值。前列腺特异性抗原和体积略有增加，在 12 个月时达到平台期；进一步增加应与衰老而非治疗有关。血脂的影响在 4 周后出现，在 6-12 个月时达到最大值。胰岛素敏感性可能在几天内改善，但血糖控制的效果仅在 3-12 个月后才显现。体脂、瘦体重和肌肉力量的变化在 12-16 周内发生，在 6-12 个月时稳定，但在数年内可能会略有持续。炎症的变化在 3-12 周内发生。骨骼的影响在 6 个月后即可检测到，并至少持续 3 年。
睾酮作用谱的时程表现出相当大的变化，这可能与睾酮制剂的药效学有关。基因组和非基因组效应、雄激素受体多态性和细胞内类固醇代谢进一步促成了这种多样性。
