Characteristic features of correcting testosterone deficiency syndrome in young men with obesity

Abstract

Aim. To assess the approaches to treatment of testosterone deficiency syndrome (TDS) in fertile (young) men with obesity.

Materials and methods. Comparative analysis of peculiarities of TDS correction in 120 men aged 21–35, suffering from class III abdominovisceral obesity, was performed taking into account the personified approach. Testosterone deficiency syndrome was detected in all the examined men. The examined patients were divided into two completely comparable groups: in group I, androgen replacement therapy was administered to patients, in group II – individual balanced diet, combined with individual physical loads and course of inhibitor of gastrointestinal lipases.

Results. In both groups, identical efficiency of TDS therapy in young men with obesity was established: when applying androgen replacement therapy and body mass decreasing therapy. However, the most favorable conditions for restoration of fertility are created when using complex multifactor therapy without testosterone preparations, since along with correction of erectile dysfunction, there is observed optimization of spermogram indices.

Conclusions. Differentiated approach to correction of testosterone deficiency syndrome among patients with obesity permits to optimize financial expenditure for treatment and preserve reproductive function. The body mass decrease leads to liquidation of testosterone deficiency syndrome, normalization of erectile function and lipid spectrum.

Keywords

obesity / fertility / testosterone deficiency syndrome / testosterone

References

[1] Голдаева П.Р., Павленко О.А. Заболеваемость ожирением среди студентов г. Томска. Современные проблемы науки и образования 2016; 6; available at: http://www.science-education.ru/ru/article/view?id=25920.

[2] Дедов И.И., Мельниченко Г.А., Роживанов Р.В., Курбатов Д.Г. Рекомендации по диагностике и лечению дефицита тестостерона (гипогонадизма) у мужчин. Проблемы эндокринологии 2016; 6: 78-80.

[3] Ожирение и избыточный вес. ВОЗ. Информационный бюллетень № 311, январь, 2015 г., available at: http://www.who.int/ mediacentre/factsheets/fs311.ru.

[4] Оранская А.Н. Значение инсулинорезистентности в нарушении половой функции мужчин (обзор). Вестник новых медицинских технологий 2009; 1: 55-56.

[5] Романова Е.В. Фертильность и половая функция мужчин при метаболическом синдроме: автореф. дис. … канд. мед. наук. М. 2009; 24.

[6] Руководство ВОЗ по исследованию и обработке эякулята человека. 5-е изд. М.: Капитал принт 2012; 305.

[7] Corradi P.F., Corradi R.B., Greene L.W. Physiology of the hypothalamic pituitary gonadal axis in the male. Urol Clin North Am 2016; 43 (2): 151-162.

[8] Petak S.M., Nankin H.R., Spark R.F. Medical guidelines for clinical practice for the evaluation and treatment of hypogonadism in adult male patients - 2002 update. American Association of Clinical Endocrinologists. Endocr Prac 2002; 6 (8): 440-456.

[9] Simon C. Testosterone deficiency - the male menopause? InnovAiT 2008; 1 (9): 625-630.

[10] Vermeulen A., Kaufman J.M., Goemaere S., van Pottelberg I. Estradiol in elderly men. Aging Male 2002; 2 (5): 98-102.

RIGHTS & PERMISSIONS

Shevchuk V.V., Kashkina N.V., Vladimirskaya N.L.