According to the results of a new study, over 50% of male patients who were diagnosed with low testosterone suffered from depression of different kinds. If some of them had only symptoms of this unpleasant condition, others had evident depression. Such patients had inactive life and suffered from severe obesity. All this information was provided on the meeting of Endocrine Society. The reporter of the study was Michael S Irwig, MD, who was associate professor of medicine and headed the Center for Andrology in George Washington University.
The doctor also said that male patients do not accept this fact. They deny it. Therefore they should pass the depression screening instrument to diagnose the condition.
The main accent in this study was mainly upon those who had low testosterone, not upon the patients with evident lack of this hormone. The specialists called this group of patients borderline men. It is clear what to do with those who suffer from evident deficiency - they are treated with testosterone. However, specialists always face problems with borderline types. Taking into account their comorbidities, they need to cope additionally with obesity and depression. Dr Irwig tries to provide comprehensive treatment for them, but he agrees that the task can be challenging.
There is no clear evidence of the fact that testosterone therapy for men with overt testosterone deficiency improves depression. As for men from borderline group, Dr Irwig calls them a big grey zone where everything is not clear. There is no clear awareness what measures should one take when he confronts them. The vagueness of this zone does not let you have clear vision. Many male patients belong to this group but it is hard to trace if testosterone level is associated with their symptoms.
Another medical doctor also commented on the subject. Cynthia A Stuenkel is a clinical professor of medicine from SanDiego, USA. She said in the interview that it is probably essential to regard depression factor as well when treating the patient with obesity and low testosterone.
Factors that complicate the situation and do not let find easy solution for men from borderline group. Focus on depression, ED and obesity that are widespread for such patients.
About 200 male patients, who were 20-77 years old, participated in the study. The main goal of the study was management of low testosterone with level that referred to borderline area. It was 200-350 ng/dL. All male participants had to undergo numerous measurements of testosterone. Additionally, they were tested to reveal their depression. The specialists used Patients Health Questionnaire-9 for this. Though there were some men among the participants with already diagnosed depression. They took antidepressants to alleviate their condition.
About 56% of participants reached the score 10 or even higher according to Patients Health Questionnaire-9 system. Antidepressants were used to treat them. The same score was revealed in 7% of patients who reported of depression symptoms but hadn't been diagnosed with depression before.
In order to compare the figures we should look at depressive issues in common people of different nationalities. The rate of population with depression was from 15 to 22%. Among them the rate of adult men with extra weight and obesity reached 5.6%. These results were obtained during National Health and Nutrition Examination Survey in 2005-2006.
About 18% of male participants in the present-day study had weight, which was either normal or below normal benchmark. The rate of men with extra weight was 39% and 43% of them were obese. About half of them did physical exercises once a week - 51%. 27% did exercises 1-3 times a week and 22% - 4-5 times a week.
The study revealed multiple health issues in them. For instance, 89% suffered from ED. About 69% of male participants experienced low sexual drive and 52 of men had lack of energy. It was also discovered that men had problems with sleep (42%) and low concentration (27%).
Dr Irwig also warned that men from the study were from the borderline group. Consequently, the results could not be applied to other clinical groups. However, he thinks that it is necessary to solve all health problems in participants with comorbidity who had simultaneously depression and obesity.
Dr Stuenkel reminds us of similar situation among female patients during menopause. They also suffer from depression at this period. At the same time, such women are not diagnosed with depression. There is, certainly, a big difference between cases of men and women because the rate of men with depression is considerably higher. For this reason, it is important to have more detailed study of this issue and look at it from different sides, looking for the link between low testosterone and obesity after which everything becomes clearer. However the third factor enters here - the factor of depression that makes the problem more complicated and interesting.
Besides, she mentioned a high percent of men with ED as an anxiety factor for cardiovascular problems. Dr Stuenkel wanted to see at what point the health issues start accumulating. She regards that presence of ED says about health problem in patients until the opposite is proven. While such things as low T or obesity are just additional factors that can aggravate the condition. Such men have high odds of cardiovascular disease. It is frequently even more serious issues then it seems in the beginning.
She recommends the specialists who treat low testosterone level in men should consider the information about menopause in women. She regards the problem with this experience in mind and thinks that it is very helpful for treatment of men as well. Dr Stuenkel tells about the experience when they provided healthy young women with hormones to prevent risk of menopause in female patients who entered high risk group. They concentrated on their symptoms. The clinicians who treat men could have looked at general picture of what was achieved for treatment of women and, probably, apply similar approach with these things in mind. It is hard not to notice some parallels in male and female groups so the solution may resemble it then. The solution may happen to be closer than it seems. Though there is much yet to be done in this respect.