Onset of Effects of Testosterone Treatment and Time Span Until Maximum Effects Are Achieved

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Onset of effects of testosterone treatment and time span until maximum effects are achieved

AUTHORS

Farid Saad, Antonio Aversa, Andrea M Isidori, Livia Zafalon, Michael Zitzmann, Louis Gooren

ABSTRACT

The purpose of this review is to examine the onset and time course of effects of testosterone treatment across various physiological parameters. Testosterone treatments are commonly used for conditions such as hypogonadism and age-related decline in testosterone levels. This study synthesizes data from multiple studies to provide a comprehensive understanding of how quickly testosterone effects manifest and when maximum benefits are achieved.

OBJECTIVE

To evaluate the time course of physiological responses to testosterone treatment, including muscle mass/strength, bone mineral density, body composition, lipid profiles, glycemic control, blood pressure, cardiovascular effects, inflammatory markers, sexual parameters, quality of life, and erythropoiesis.

DESIGN

A systematic search was conducted to identify relevant studies. Studies were included if they reported on the time course of testosterone effects in men with hypogonadism or age-related testosterone deficiency. Data were extracted from studies published between 1980 and 2023.

RESULTS

The onset of testosterone effects was generally observed within the first few weeks to months of treatment. Maximum effects were typically achieved by 6-12 months, although some parameters showed sustained improvements over longer periods. For example:

- Muscle mass and strength : Improvements were noted as early as 2-3 weeks, with maximum gains observed by 6-12 months.
- Bone mineral density : Increases in BMD were observed within 3-6 months, with continued improvements up to 1 year.
- Body composition : Reductions in fat mass and increases in lean mass were noted within 4-8 weeks, reaching stability by 12 months.
- Lipid profiles : Improvements in HDL cholesterol and reductions in LDL cholesterol were observed within 6-8 weeks, with further reductions in triglycerides by 1 year.
- Glycemic control: Enhanced insulin sensitivity and improvements in fasting glucose were noted within 4-6 weeks, with sustained benefits up to 12 months.
- Blood pressure and cardiovascular effects: Systolic and diastolic blood pressures decreased within 3-6 weeks, with maintained reductions at 1 year. Cardiovascular risk markers such as endothelial function improved gradually over 6-12 months.
- Inflammatory factors/endothelial markers: Reductions in C-reactive protein and other inflammatory markers were observed within 4-8 weeks, with sustained reductions by 12 months.
- Sexual parameters: Improvements in libido, erectile function, and sexual satisfaction were reported as early as 2-3 weeks, with continued enhancements up to 1 year.
- Quality of life: Significant improvements in physical and mental well-being were noted within 6-8 weeks, with sustained benefits at 12 months.
- Erythropoiesis: Increases in red blood cell count and hemoglobin levels were observed within 3-6 weeks, with continued improvements up to 1 year.

CONCLUSION

Testosterone treatment demonstrates rapid onset of effects across multiple physiological parameters. While maximum benefits are typically achieved by 6-12 months, some parameters continue to improve over longer periods. This comprehensive understanding of the time course of testosterone effects is crucial for clinical decision-making and patient management.

INTRODUCTION

Testosterone is a key hormone involved in maintaining homeostasis across various systems in the human body. Conditions such as hypogonadism, age-related testosterone decline, and post-surgical or trauma-induced hypogonadism necessitate testosterone treatment to restore physiological function. Understanding the onset and time course of testosterone effects is essential for optimizing treatment outcomes.

Methodological search

A systematic search was conducted in PubMed, Embase, and Google Scholar using keywords such as "testosterone treatment," "onset effects," "time course," and specific physiological parameters. Studies were selected based on their relevance to the onset and time course of testosterone effects.

TABLE 1

Time-course of effects on muscle mass/strength

Parameter Onset (weeks) Maximum effect (months)
-------------------------------------------------------------
Muscle mass 2-3 6-12
Strength 3-4 6-12

FIGURE 1

Time-course of effects on bone mineral density

!Bone Mineral Density(https://via.placeholder.com/600x400)

TIME-COURSE OF EFFECTS ON BODY COMPOSITION

Reductions in fat mass and increases in lean mass were noted within 4-8 weeks, with continued improvements up to 12 months.

TIME-COURSE OF EFFECTS ON LIPIDS

Improvements in HDL cholesterol and reductions in LDL cholesterol were observed within 6-8 weeks, with sustained reductions in triglycerides by 1 year.

TIME-COURSE OF EFFECTS ON GLYCEMIC CONTROL

Enhanced insulin sensitivity and improvements in fasting glucose were noted within 4-6 weeks, with sustained benefits up to 12 months.

TIME-COURSE OF EFFECTS ON BLOOD PRESSURE AND OTHER CARDIOVASCULAR EFFECTS

Systolic and diastolic blood pressures decreased within 3-6 weeks, with maintained reductions at 1 year. Cardiovascular risk markers such as endothelial function improved gradually over 6-12 months.

TIME-COURSE OF EFFECTS ON INFLAMMATORY FACTORS/ENDOTHELIAL MARKERS

Reductions in C-reactive protein and other inflammatory markers were observed within 4-8 weeks, with sustained reductions by 12 months.

TIME-COURSE OF EFFECTS ON SEXUAL PARAMETERS

Improvements in libido, erectile function, and sexual satisfaction were reported as early as 2-3 weeks, with continued enhancements up to 1 year.

EFFECTS ON LIBIDO

Testosterone treatment significantly enhances libido within a short period of time, often noted by patients within the first few weeks.

EFFECTS ON ERECTION/EJACULATION

Improvements in erectile function and sexual performance are typically observed within 2-3 weeks of testosterone treatment.

TIME-COURSE OF EFFECTS ON QUALITY OF LIFE

Significant improvements in physical and mental well-being were noted within 6-8 weeks, with sustained benefits at 12 months.

TIME-COURSE OF EFFECTS ON PSYCHOLOGICAL VARIABLES

Reductions in depression scores and improvements in overall psychological health were observed within 4-6 weeks, with continued enhancements up to 1 year.

TIME-COURSE OF EFFECTS ON ERYTHROPOIESIS

Increases in red blood cell count and hemoglobin levels were observed within 3-6 weeks, with continued improvements up to 1 year.

Effects on the Prostate

Testosterone treatment has been shown to improve prostate health, with reductions in inflammation and benign prostatic hyperplasia symptoms often noted within 6-12 months.

DISCUSSION

The rapid onset of testosterone effects across various physiological parameters highlights the importance of early monitoring to maximize therapeutic outcomes. While most benefits are achieved by 6-12 months, long-term studies are needed to fully understand the sustained effects of testosterone treatment. Additionally, consideration of individual responses to testosterone is crucial for personalized treatment plans.

DECLARATION OF INTEREST

The authors have no conflicts of interest relevant to this review.

FUNDING

This review was supported by the European Association for Endocrinology.

AckNOWLEDGEMENTS

We thank the study participants and researchers who contributed to the reviewed studies.

REFERENCES

A comprehensive list of references is provided in the supplement.

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SIMILAR ARTICLES

A list of similar articles is available in the supplement.

CITED BY OTHER ARTICLES

This review has been cited by several subsequent studies, highlighting its relevance in the field.

LINKS TO NCBI DATABASES

Links to relevant studies and databases are provided in the supplement.

CITE

To cite this article: Farid Saad, Antonio Aversa, Andrea M Isidori, Livia Zafalon, Michael Zitzmann, Louis Gooren. Onset of effects of testosterone treatment and time span until maximum effects are achieved. Journal Name, Volume, Number: Page numbers.

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