This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (71)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Physiological Serum Testosterone and Elevated Dihydrotestosterone Levels

Glenn R. Cunningham, MD; Emilia Cordero, RN; Jack I. Thornby, PhD

JAMA. 1989;261(17):2525-2530.

Abstract
Testosterone was administered transdermally to hypogonadal men under three protocols. In the first protocol, it was shown that peak levels of testosterone were achieved three to eight hours after scrotal application of a transdermal therapeutic system containing 5, 10, or 15 mg of testosterone, and values at 22 hours were greater than 60% of peak values. In the second protocol, patients were treated with 10-mg systems for four weeks followed by 15-mg systems for eight weeks. Serum samples were obtained three to five hours after application of the transdermal therapeutic system. Testosterone increased from a pretreatment level (mean ± SE) of 1.5 ± 0.4 nmol/L to 15.2 ±3.4 nmol/L at four weeks, 18.6 ± 3.3 nmol/L at eight weeks, and 17.3 ± 2.8 nmol/L at 12 weeks. The serum testosterone/dihydrotestosterone (DHT) ratio fell from 4.53 to 2.47 at four weeks and was similar at eight and 12 weeks, reflecting a greater rise in DHT with this route of treatment (normal testosterone/DHT ratio, 9/1 to 12/1). Eight patients were treated with the 15-mg systems for an additional year. Seven of the eight were compliant and maintained serum testosterone levels (at six time points from two to 12 months [mean ± SE]) ranging from 11.5 ±1.2 to 44.9 ±2.4 nmol/L. It was possible to achieve physiological serum levels of testosterone by transdermal administration of testosterone in two thirds of our hypogonadal men.

(JAMA. 1989;261:2525-2530)

Author Affiliations
From the Medicine (Dr Cunningham and Ms Cordero) and Psychiatry (Dr Thornby) Services, Veterans Administration Medical Center and Baylor College of Medicine, Houston.

Footnotes
Reprint requests to Endocrinology Section (111E), Veterans Administration Medical Center, 2002 Holcombe Blvd, Houston, TX 77030 (Dr Cunningham).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Testosterone Replacement Therapy for Older Men
Wald et al.
J Androl 2006;27:126-132.
FULL TEXT  

New Testosterone Buccal System (Striant) Delivers Physiological Testosterone Levels: Pharmacokinetics Study in Hypogonadal Men
Wang et al.
J. Clin. Endocrinol. Metab. 2004;89:3821-3829.
ABSTRACT | FULL TEXT  

Testosterone Gel Supplementation for Men With Refractory Depression: A Randomized, Placebo-Controlled Trial
Pope et al.
Am. J. Psychiatry 2003;160:105-111.
ABSTRACT | FULL TEXT  

Long-Term Pharmacokinetics of Transdermal Testosterone Gel in Hypogonadal Men
Swerdloff et al.
J. Clin. Endocrinol. Metab. 2000;85:4500-4510.
ABSTRACT | FULL TEXT  

Testosterone--Fountain of Youth or Drug of Abuse?
Hayes
J. Clin. Endocrinol. Metab. 2000;85:3020-3023.
FULL TEXT  

Transdermal Testosterone Gel Improves Sexual Function, Mood, Muscle Strength, and Body Composition Parameters in Hypogonadal Men
Wang et al.
J. Clin. Endocrinol. Metab. 2000;85:2839-2853.
ABSTRACT | FULL TEXT  

Pharmacokinetics of Transdermal Testosterone Gel in Hypogonadal Men: Application of Gel at One Site Versus Four Sites: A General Clinical Research Center Study
Wang et al.
J. Clin. Endocrinol. Metab. 2000;85:964-969.
ABSTRACT | FULL TEXT  

Pharmacokinetic Characteristics, Efficacy, and Safety of Buccal Testosterone in Hypogonadal Males: A Pilot Study
Dobs et al.
J. Clin. Endocrinol. Metab. 1998;83:33-39.
ABSTRACT | FULL TEXT  

Issues in detecting abuse of xenobiotic anabolic steroids and testosterone by analysis of athletes' urine
Catlin et al.
Clin. Chem. 1997;43:1280-1288.
ABSTRACT | FULL TEXT  

Emerging Issues in Androgen Replacement Therapy
Bhasin and Bremner
J. Clin. Endocrinol. Metab. 1997;82:3-8.
FULL TEXT  

Review: Medication Delivery in the Short-Bowel Syndrome
McFadden et al.
JPEN J Parenter Enteral Nutr 1993;17:180-186.
ABSTRACT