For men with low testosterone, more severe symptoms of testosterone deficiency syndrome (TDS) could be associated with higher cardiovascular risk, according to Spanish researchers.
TDS becomes more common as men age. The condition can bring about a number of psychological, metabolic, and sexual issues. However, TDS may be underdiagnosed, as many symptoms overlap with other medical conditions. Also, some men with TDS have mild symptoms or no symptoms at all.
Because low testosterone is associated with serious health problems like diabetes, metabolic syndrome, and cardiovascular disease, the researchers wondered whether men with mild or no symptoms would have the same cardiovascular risks as those who did.
To learn more, they analyzed data from 999 men over age 45 (mean age 61.2) with confirmed or suspected low testosterone.
The men were assessed for metabolic syndrome. Erectile dysfunction (ED) was evaluated using the 5-item International Index of Erectile Function. The men also completed the Ageing Male Symptoms (AMS) scale, which assessed somatovegetative, psychological, and sexual issues.
Ninety-seven percent of the men had erectile dysfunction; about half of that group had moderate or severe ED.
On the AMS scale, sexual symptoms were the most prevalent, with almost 96% of the men experiencing decreased ability to perform, 96% having fewer morning erections, and 94% feeling decreased desire/libido. “Physical exhaustion/lacking vitality” and “decline in the feeling of general wellbeing” were problems for over 90% of the men as well.
Three-quarters of the men with moderate/severe TDS symptoms had metabolic syndrome compared to 58% of the men with mild/no symptoms.
Also, men with moderate/severe TDS symptoms were more likely to be older and obese. They were also more likely to have more severe ED and total testosterone levels of less than 8 nmol/L.
“The results of our study. . . suggest that in men with low [testosterone], severity of TDS-related symptoms, as assessed by the AMS scale, is associated to a greater likelihood of [metabolic syndrome],” the authors wrote.
They added, “Therefore, besides their utility to raise the suspicion of TDS in healthy men, severity of TDS-related symptoms may be useful to suspect a higher [cardiovascular] and metabolic risk in men with low [testosterone], which reflect the overall poor health status of these men.”
The authors noted several limitations, explaining that there are currently no official guidelines for evaluating TDS symptoms and questionnaires are not typically used for TDS diagnosis. Also, their analysis was based on one testosterone measurement for each man. Generally, more than one measurement would be used to confirm low testosterone levels.
The study was first published online in June in The Journal of Sexual Medicine.
The Journal of Sexual Medicine
García-Cruz, Eduard, MD, et al.
“Marked Testosterone Deficiency-Related Symptoms May be Associated to Higher Metabolic Risk in Men with Low Testosterone Levels”
(Full-text. First published online: June 26, 2014)