Prevalence and Etiology of Hypogonadism in Young Men With Chronic Spinal Cord Injury: A Cross-Sectional Analysis From Two University-Based Rehabilitation Centers.
Shannon D Sullivan, Mark S Nash, Eshetu Tefera and 3 others
PMID 27871967WHAT IT FOUND
Young men with chronic spinal cord injury had low testosterone: 25% by total testosterone and 36% by free testosterone.
Low total testosterone was more common than in age-matched men without injury. Tetraplegia, older age, and higher body fat were associated with lower testosterone.
Key findings
01In 58 young men with chronic spinal cord injury, low total testosterone was found in 15 men (25%) and low free testosterone in 21 men (36%).
02Low total testosterone was more common in men with chronic spinal cord injury than in similarly aged men without spinal cord injury: 25% versus 6.7%.
03Among 23 men with low total or free testosterone, 9 had low LH and FSH, 5 had high LH or FSH, and 9 had normal levels, consistent with secondary, primary, or mixed hypogonadism.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 58 men were studied, and all had chronic motor complete injury from C5 to T12, so results may not apply to other spinal cord injury levels or durations. Hormone levels were measured once, not repeated, so single morning values may not reflect long-term status. The study did not measure prolactin, sexual function, symptoms of hypogonadism, or physical exam findings. Comparison with NHANES III used historical controls, different race and ethnicity composition, and stricter exclusions in the spinal cord injury cohort. The study was cross-sectional and did not test treatment outcomes, so it cannot show that testosterone deficiency caused health problems or that treatment helps.
Declared interests
The authors reported no financial conflicts of interest.
The easy way to misread this
Do not read the higher testosterone deficiency rate as proof that every young man with chronic spinal cord injury needs testosterone treatment. This was a cross-sectional study of 58 men, hormone levels were measured once, and no symptoms, sexual function, or treatment outcomes were tested.