Predictors and clinical consequences of starting androgen therapy in men with low testosterone: results from the SIAMO-NOI registry

Purpose Management of late onset hypogonadism (LOH)is not homogenous. The aim of the study is to observe themanagement of patients with low testosterone (T) in highlyspecialized Italian centres.Methods The SIAMO-NOI is an observational longitudinaldisease registry for the evaluation of the clinical managementof patients with low T levels (total T < 12 nmol/L,calculated free T < 225 pmol/l or already in treatment)in 15 Italian centers members of the Italian Society forAndrology and Sexual Medicine (SIAMS). Clinical and biochemical data were collected for four visits during12 months of observation.Results 432 patients (mean age 50.9 ± 14.9 years) wereenrolled. Of them, 247 men were receiving androgentherapy, whereas 145 were naive. After the first visit (V0),80 men started androgen therapy, whereas 55 remaineduntreated during the entire observation. Younger age [oddsratio (OR) 0.57 (0.35–0.92)], total T < 8 nmol/l [OR 4.69(1.59–13.81)], complaining at least one sexual symptom[OR 11.55 (2.01–66.35)] and reporting more severelower urinary tract symptoms [OR 1.27 (1.01–1.60)] predictedstarting an androgen therapy. Sixty-four men startedtherapy immediately after V0 and maintained it until theobservation end. When compared to V0, they reported anincrease in all the domains of the International Index of Erectile Function-15 (IIEF-15), in the sexual and physicalsubdomains of the Aging Male Scale as well as inthe International Prostate Symptom Score. Conversely,the untreated group reported a significant improvement,although lower than the treated group, only in the erectilefunction domain of the IIEF-15.Conclusions Management of LOH in SIAMS centresis in line with the international guidelines and the newestknowledge about the role of T on prostate health. Androgentherapy is associated with an improvement in all the aspectsof sexual life and in the perception of physical strength.