Effects of Intermission and Resumption of Long-term Testosterone Replacement Therapy on Body Weight

Clin Endocrinol. 2016;84(1):107-114

Purpose:

In addition to primary and secondary ('classical') hypogonadism, hypogonadism occurring in middle-aged and elderly men has been recognized. There is evidence that restoring testosterone levels to normal improves body weight, serum lipids and glucose levels.

Participants:

In an ongoing registry study in a urology clinic, 262 hypogonadal men received testosterone for a maximum of 11 years. They were younger (mean 49·23 ± 6·72 years) than most of the other patients (mean age 62·28 ± 7·34 years). All subjects had sought urological consultation for erectile dysfunction. A deficient testosterone serum testosterone level and the presence of symptoms as assessed by the Aging Males' Symptoms (AMS) scale were used for the definition of hypogonadism.^[18] All men received treatment with injectable testosterone replacement therapy.

What Happens when you Stop Testosterone Replacement Therapy (TRT):

Body weight, Body Mass Index (BMI) and waist circumference increased significantly. Fasting glucose and serum HbA_1c returned to baseline levels or were even higher. Similar patterns were observed for serum cholesterol, LDL cholesterol, triglycerides, HDL cholesterol, total cholesterol/HDL ratio and non-HDL cholesterol, as well as systolic blood pressure.

Results of Restarting TRT:

Our results strongly indicate that the beneficial changes induced by normalization of serum testosterone are not sustained when TRT is stopped and serum levels return to pretreatment levels. But these beneficial effects (improvement in body weight, BMI, HgbA1c, lipids, and blood pressure) do return again upon the restarting of TRT normal serum testosterone levels.