Nasal gel ups testosterone in men with functional hypogonadism

Use of the short-acting 4.5% nasal testosterone gel Natesto leads to increased testosterone levels while maintaining semen parameters in men, indicating its potential as a safe and effective treatment for patients with functional hypogonadism, results of a trial have shown.

This single-centre, open-label, single-arm trial was conducted between November 2017 and September 2019 at the University of Miami, US. The study included men aged 18–55 years who were diagnosed with symptomatic hypogonadism (total testosterone <300 ng/dl on two occasions). Excluded were those with azoospermia, vasectomy, or total sperm count <5 million.

Sixty men met the eligibility criteria, of whom 44 and 33 patients were assessed for testosterone at 3 and 6 months, respectively. Thirty-one patients (90.9 percent) achieved a normal testosterone level (>300 ng/dl) at 6 months.

Of the patients, 81.8 percent and 72.7 percent maintained follicle stimulating hormone and luteinizing hormone levels, respectively, within the normal range at 6 months. Moreover, 88.4 percent and 93.9 percent of men maintained total motile sperm count >5 million over the treatment period at 3 months and 6 months, respectively.

Statistically significant improvements were observed on International Index of Erectile Function sexual desire and overall satisfaction domains at 6 months.

“Long-term studies beyond 6 months are needed before we can safely prescribe nasal testosterone gel for men interested in fertility,” the investigators said.