Onset of effects of testosterone treatment and time span until maximum effects are achieved

Farid Saad, Antonio Aversa, Andrea M Isidori, Livia Zafalon, Michael Zitzmann, Louis Gooren, Farid Saad, Antonio Aversa, Andrea M Isidori, Livia Zafalon, Michael Zitzmann, Louis Gooren

Abstract

Objective: 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.

Design: Literature data on testosterone replacement.

Results: 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.

Conclusion: 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.

Figures

Figure 1
Figure 1
Time-course on body composition and strength.
Figure 2
Figure 2
Time-course on lipids.
Figure 3
Figure 3
Time-course on glucose and insulin.
Figure 4
Figure 4
Time-course on sexual parameters.
Figure 5
Figure 5
Time-course on hematocrit and prostate.

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Source: PubMed

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