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An expert shares their approach to testosterone therapy in men with hypogonadism
"I think that testosterone is really a medication that can be life changing for so many men, says Helen L. Bernie, DO, MPH.
"I think that testosterone is really a medication that can be life changing for so many men, says Helen L. Bernie, DO, MPH.
In light of the FDA’s recent announcement of class-wide labeling changes for testosterone products, Urology Times® spoke with Helen L. Bernie, DO, MPH, regarding the implications of the changes for her practice. Bernie is director of sexual and reproductive medicine at Indiana University and an assistant professor of urology at Indiana University School of Medicine in Indianapolis, Indiana.
When asked what the most significant challenges are in differentiating between age-related decline and clinically significant hypogonadism, and how she navigates these challenges in light of the FDA's continued caution, Bernie explained, “I think most men in our practice, or at least certainly most men that I see in general that may have age-related decline, also have comorbidities, which we know can lower testosterone levels—diabetes, metabolic syndrome, obesity, anemia, things like that. So I find that often it's really challenging to isolate the exact mechanism for some men as to why they have low testosterone levels. But I think what's important is that we do know that low testosterone can cause significant symptoms such as fatigue, decreased endurance and strength, weakness, loss of lean muscle mass, cognitive decline, sexual dysfunctions like low libido, osteoporosis, and potentially cardiovascular risk as well. We also know that testosterone therapy can improve many of these symptoms and can be life changing for some men.”
Bernie added that she treats symptomatic men with low testosterone “irrespective of the reason or medical condition of why they have [low] testosterone.”
“We also have great data that show men who have diabetes or have metabolic syndrome, [that] by treating them with testosterone, not changing anything else, not diet or exercise, but just treating them with testosterone, it helps actually lower their hemoglobin A1c levels and helps lower their glucose levels. For men who are on insulin, it decreases the amount of insulin requirements that they need to treat their diabetes. So I think that testosterone is really a medication that can be life changing for so many men,” Bernie said.
