Zucker Isaac, Rainer Quinn, Pai Raghav K, Ramasamy Ranjith, Masterson Thomas A
Medicine, Florida International University, Miami, USA.
Urology, University of Miami, Miami, USA.
Cureus. 2022 May 31;14(5):e25543. doi: 10.7759/cureus.25543. eCollection 2022 May.
Background Male hypogonadism has a prevalence of about 6% and is defined by two-morning testosterone levels below 300 ng/dl associated with symptoms. This definition presents a challenging problem for patients without other medical problems but with symptoms of low testosterone (T) who do not meet the biochemical criteria for therapy. Objectives Our objective was to evaluate changes in symptoms and side effects in men with T levels >300ng/dL using human chorionic gonadotropin (hCG) monotherapy for the treatment of hypogonadal symptoms. Methods After IRB approval, 31 male patients treated with hCG monotherapy for low T symptoms were retrospectively reviewed. We evaluated changes in hormones, hypogonadal symptoms, and the incidence of thromboembolic events before and after starting hCG. Results We found subjective improvement in erectile dysfunction, 86% (19/22), and libido, 80% (20/25), with no patient experiencing a thromboembolic event. In addition, no change was observed in the follicle-stimulating hormone, luteinizing hormone, estradiol, hematocrit, hemoglobin A1c, and prostate-specific antigen. Conclusion Weekly treatment with hCG appears safe and can improve hypogonadal symptoms in patients with T >300 ng/dl without changes to hematocrit, prostate-specific antigen, and hemoglobin A1c.
男性性腺功能减退的患病率约为6%，其定义为清晨两次睾酮水平低于300 ng/dl并伴有相关症状。对于没有其他医疗问题但有低睾酮（T）症状且不符合治疗生化标准的患者，这一定义带来了一个具有挑战性的问题。目的：我们的目的是评估使用人绒毛膜促性腺激素（hCG）单一疗法治疗性腺功能减退症状的男性，其T水平>300ng/dL时症状和副作用的变化。方法：经机构审查委员会（IRB）批准后，对31例接受hCG单一疗法治疗低T症状的男性患者进行回顾性分析。我们评估了开始使用hCG前后激素、性腺功能减退症状以及血栓栓塞事件发生率的变化。结果：我们发现勃起功能障碍主观改善率为86%（19/22），性欲主观改善率为80%（20/25），且无患者发生血栓栓塞事件。此外，促卵泡激素、促黄体生成素、雌二醇、血细胞比容、糖化血红蛋白A1c和前列腺特异性抗原均未观察到变化。结论：每周使用hCG治疗似乎是安全的，并且可以改善T>300 ng/dl患者的性腺功能减退症状，而不会改变血细胞比容、前列腺特异性抗原和糖化血红蛋白A1c。
