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115 EXOGENOUS TESTOSTERONE ALONE OR WITH FINASTERIDE INCREASES PHYSICAL PERFORMANCE, GRIP STRENGTH, AND LEAN BODY MASS IN OLDER MEN WITH LOW SERUM TESTOSTERONE
  1. S. T. Page,
  2. J. K. Amory,
  3. F. D. Bowman,
  4. B. D. Anawalt,
  5. A. M. Matsumoto,
  6. W. J. Bremner,
  7. J. L. Tenover
  1. University of Washington School of Medicine, Seattle

Abstract

Purpose Testosterone (T) therapy in older men with low serum T levels increases lean body mass (LBM) and decreases fat mass (FM). These changes might improve physical performance and strength; however, it has not been established whether T therapy improves functional outcome in older men. Moreover, concerns exist about the impact of T therapy on the prostate in older men. The administration of finasteride, which blocks the conversion of T to the more potent androgen, dihydrotestosterone (DHT), attenuates the impact of T replacement on prostate size and PSA. We hypothesized that T replacement in older hypogonadal men would improve physical performance and that the addition of finasteride to T would not impact these T-induced improvements.

Methods and Results Seventy men with low serum T (≤350ng/dl), age 65 and older, were randomly assigned to receive one of three regimens for 36 months: T enanthate 200 mg intramuscularly every two weeks with placebo pills daily (T-only), T enanthate 200 mg every two weeks with 5 mg finasteride daily (T+F), or placebo injections and pills (placebo). We obtained serial measurements of timed physical performance, grip strength, lower extremity strength, body composition (by DEXA), fasting cholesterol profiles and hormones. After 36 months, T therapy significantly improved performance in a timed functional test when compared to baseline and placebo (4.3±1.6% [mean± SEM, T-only] and 3.8±1.0% [T+F] vs. -5.6±1.9% for placebo, [P≤0.002 for both T and T+F versus placebo; and increased handgrip strength compared to baseline and placebo [P≤0.05]. T therapy increased LBM, and decreased FM, total cholesterol, low-density lipoprotein (LDL-C), and leptin, without affecting high-density lipoprotein (HDL), adiponectin or fasting insulin levels.

Summary T therapy in older men with low serum T improves physical performance, strength, LBM, FM, and serum cholesterol over 36 months both when administered alone or when combined with finasteride.

Conclusion These data suggest that T therapy may improve functional outcome in older men with low serum T and that DHT is likely not essential for these beneficial effects of T.

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