TESTOSTERONA ENVEJECIMIENTO

1: J Sex Med. 2007 May;4(3):558-66.
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Canadian Society for the Study of the Aging Male: Response to Health Canada's Position Paper on Testosterone Treatment.
Bain J,
Brock G,
Kuzmarov I;
for the International Consulting Group.
Department of Medicine, Division of Endocrinology and Metabolism, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
Introduction. Testosterone treatment of older symptomatic men with reduced testosterone availability is increasing. There is an expanding body of literature to support such treatment in a large subset of aging men, but there has not yet been a long-term placebo-controlled double-blind study of several thousand men to confirm the efficacy and safety of this treatment as indicated by shorter-term studies. The absence of a long-term study has been used by governmental agencies as a limiting factor in providing full access and payment for this treatment in government-sponsored health care plans. Health Canada issued a testosterone analysis document to the pharmaceutical industry, the implications of which may make it more difficult for appropriate patients to receive such treatment. The Canadian Society for the Study of the Aging Male (CSSAM) believed it had an obligation to advocate on behalf of men requiring this treatment. Aim. To provide an international consensus on the use of testosterone treatment in appropriately selected hypogonadal men. Main Outcome Measure. To determine whether the literature supports the use of testosterone treatment in a selected population of hypogonadal men, to achieve consensus on this point among an international consulting group, and to transmit this view to health care workers and insuring and governmental agencies. Methods. Email communication among the consulting group to prepare a response to Health Canada, followed by a review of appropriate literature and international practice guidelines, incorporating the literature and guidelines together with the CSSAM letter and Health Canada's response. Result. The literature and international guidelines support the initiation of testosterone therapy in symptomatic hypogonadal men, recognizing that there is no universal agreement on the criteria for the diagnosis of hypogonadism in each suspected case. The need for careful monitoring of such men is stressed. Conclusion. CSSAM acted as an advocate for hypogonadal men who may benefit from treatment with testosterone. Short-term studies and 60 years of experience with testosterone therapy attest to its efficacy. Long-term studies are desirable, but it may take many years before results could be forthcoming. There is no evidence to suggest that testosterone treatment increases the risk of prostate cancer or cardiovascular disease. Current evidence suggests, in fact, that testosterone treatment may be cardioprotective. It is important to bring this information to the attention of governments and insuring agencies through the collaboration of groups devoted to the diagnosis and treatment of hypogonadal men.
PMID: 17498097 [PubMed - in process]
TRADUCCION . El tratamiento de hombres viejos sintomáticos con testosterona con reducida disponibilidad de la hormona es creciente. Hay una expansiva literatura que soporta tal tratamiento en un gran grupo de hombres viejos pero aún no existe un estudia a largo plazo placebo y doble ciego para confirmar su eficacia y seguridad como lo indicant los trabajos de corto plazo.
La ausencia de estos trabajos de largo plazo ha sido usada por las agenciaa guvernamentales como un factor limitante en proporcionar el total acceso y el pago por este tratamiento por los auspiciadores de planes de salud. La sociedad canadiense para el estudio de envejecimiento masculino ( CSSAM) cree que tiene la obligación de abocarse al grupo de pacientes que requiern este tratamiento. Nuestro objeto fue proporcionar un consenso internacional acerca de el uso de tratamiento con testosterona en seleccionados varones hipogonádicos. Para determinar si la literatura soporta el uso de testosterona en varones hipogonádicos, para obtener un concenso en este punto y entre un un grupo inter4nacional de consulta y para trasmitir esa visión a los médicos tratantes y asegurar un apoyo de las agencias gubernamentales. Comunicación via e mail entre los grupos consultantes para preparar una respuesta a Health Canadá seguido de una revision de la literature apropiada y gías de practica médica internacional junto con La CSSAM. Concluyeron en lo siguiente;



La CSSAN actua como propiciador de hipogonádicos quienes pueden beneficiarse con el tratamiento con testoster Estudios de corto plazo y sesenta años de wexperiencia con testosterona enfocan hacia su eficacia. Estudios a largo plazo son deseables pero puede tomar muchos años antes que los estudios puedan ser confirmatorios. No hay evidencia de que el tratamiento con testosterona eleve el riesgo de cancer de próstata o accidente vascular de hecho el tratamiento con la hormona puede ser cardioprotector. Es importante destacar esta información para ser tomados en cuenta por los governantes y agencies de seguridad a traves de la colaboración de grupos abocados al tratamiento y el diagnóstico de hombres con hipogonadismo.