MP59-17 COMPARISON OF SHORT-ACTING VS. LONG-ACTING TESTOSTERONE GELS ON FSH
Bibliographic record
Abstract
You have accessJournal of UrologySexual Function/Dysfunction: Basic Research & Pathophysiology (MP59)1 Apr 2019MP59-17 COMPARISON OF SHORT-ACTING VS. LONG-ACTING TESTOSTERONE GELS ON FSH Thomas Masterson*, Gerwin Westfield, Nathan Bryson, Ross Ormsby, and Ranjith Ramasamy Thomas Masterson*Thomas Masterson* More articles by this author , Gerwin WestfieldGerwin Westfield More articles by this author , Nathan BrysonNathan Bryson More articles by this author , Ross OrmsbyRoss Ormsby More articles by this author , and Ranjith RamasamyRanjith Ramasamy More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556729.33156.b2AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Low testosterone (low T) affects around 38.7% of men over the age of 45 and prescriptions to younger men is on the rise. Exogenous long-acting testosterone replacement therapy (TRT) can act as a contraceptive . Very few contemporary studies have evaluated the effect of TRT on gonadotropins and reproduction. Recently, Natesto®, a short acting intranasal gel given three times daily, was demonstrated to increase serum total testosterone while maintaining normal serum levels of gonadotropins. We hypothesized that due to Natesto's pulsatile (ultradian) systemic exposure, which simulates the pulsatile release of gonadotropin hormones from the HPG axis, it may have lesser effect on gonadotropins than longer acting testosterone gel preparations. We compared the effect of Natesto to a topical testosterone gel on serum FSH, as evidence has shown that FSH is critical for fertility and spermatogenesis METHODS: We performed a post hoc analysis of previously published studies on exogenous testosterone and FSH. Two studies were identified . One prescribing Natesto (11.0mg testosterone/dose, tid), and the other Testim® (50mg, 1% transdermal testosterone). We compared the changes in FSH after 3 months of therapy and in particular attempted to identify characteristics of men who had FSH < 1.5IU/ml as it was considered the lower limit of normal (LLN ). Results are presented as means (SD). Categorical variables were tested for statistical significance RESULTS: A total of 297 men were prescribed Natesto and 31 hypogonadal men were prescribed Testim (1%). Among the men who were prescribed Natesto, FSH changed from 8.2(11.0) to 5.5 (9.3) after 3 months. A total of 90 (30.3%) men had FSH < 1.5 after 3 months and 39 (12.1%) were ≤ 0.5. There were no differences in age or BMI between men who had undetectable FSH and those who did not. Among the 31 men who were prescribed Testim, FSH levels decreased from 6.0 (2.9) at baseline to 2.4 (2.8). Of the 31 men, 13 (41.9%) had FSH below LLN after 3 months. CONCLUSIONS: Testosterone therapy using Natesto increases testosterone while maintaining normal levels of FSH in 70% of men, compared to only 58% in steady state testosterone preparations. Identifying strategies to increase testosterone while simultaneously maintaining reproductive potential is critical for treating young men with low testosterone who wish to preserve fertility. Source of Funding: none Miami, FL; Denver, CO; Mississauga, Canada; Miami, FL© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e867-e867 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Thomas Masterson* More articles by this author Gerwin Westfield More articles by this author Nathan Bryson More articles by this author Ross Ormsby More articles by this author Ranjith Ramasamy More articles by this author Expand All Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.030 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".