Metabolic and behavioral effects of high-dose, exogenous testosterone in healthy men.
Level 4 - case-series / case-control
Uncontrolled prospective before-and-after interventional study without a control group
PubMed 8045977 · doi:10.1210/jcem.79.2.8045977
What was done
Nineteen healthy men were evaluated across three phases: a 3-month pretreatment baseline, a 20-week treatment period with weekly intramuscular testosterone injections (200 mg/week), and a 4- to 6-month recovery period until sperm counts normalized. Investigators measured plasma lipids (HDL, HDL2, HDL3, apoprotein AI, LDL, triglycerides), markers of calcium metabolism (serum and urinary calcium, intact PTH, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D), body weight, acne, and self-reported sexual and aggressive behaviors.
What was found
Exogenous testosterone increased serum testosterone and estradiol levels. Plasma HDL cholesterol decreased within the first month and dropped by 13 +/- 2% (P < 0.05) by the end of treatment, accompanied by significant reductions in HDL2, HDL3, and apoprotein AI; LDL cholesterol and triglycerides did not change. Serum calcium decreased slightly but significantly, urinary calcium was unchanged, intact PTH increased by 84 +/- 17% (P < 0.05), and 25-hydroxyvitamin D decreased by 16 +/- 4% (P < 0.05). Body weight increased by 4.0 +/- 0.5 kg, and approximately half the participants developed mild acne. Self-reported sexual behavior (intercourse frequency, masturbation, relationship satisfaction) and aggressive behavior did not change significantly, though non-significant upward trends in arousal and spontaneous erections were noted. All metabolic, lipid, and physical changes returned to baseline during recovery.
Why it matters
This study provides evidence on the non-reproductive physiological effects of high-dose testosterone, demonstrating that supraphysiological doses cause fully reversible reductions in HDL cholesterol and shifts in calcium-regulating hormones without markedly altering behavioral profiles in healthy men.
Limits
The study lacked a randomized placebo control group. The sample size was small (n = 19), behavioral outcomes relied on subjective self-reporting, and the 20-week exposure was too short to assess long-term cardiovascular or bone health consequences.
Cited by
- supports Exogenous testosterone and androgen administration lowers and suppresses HDL cholesterol levels.