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A large number of clinical trials have demonstrated a positive effect of TRT on BMD. Most studies of TRT in hypogonadal men have been uncontrolled, relatively short-term, and involved small numbers of subjects with a variety of causes for their hypogonadism. Snyder et al. [ 12 ] showed that transdermal testosterone therapy increased spine BMD after 36 months of treatment (Testoderm, 6 mg per 24 hour) but found no changes in femoral BMD. Wang et al. [ 13 ] studied BMD and bone turnover markers in 123 patients treated with long-term testosterone gel, including 27 patients with secondary hypogonadism due to pituitary tumors and hypothalamic tumors. They found a decrease in urine N-telopeptide in the first 6 months of treatment and a progressive and gradual increase in the BMD of the spine and hip. This increase in BMD was more marked in the spine than in the hip [ 13 ]. Our aim was to investigate BMD changes in postoperative pituitary tumor patients treated with TRT. Although many previous studies provided information on BMD levels only after 1 or 2 years of treatment, our study utilized a longer follow-up period of up to 99 months. However, our study has some limitations. First, many of our patients were receiving hormone replacement therapy with L-thyroxine and/or hydrocortisone due to panhypopituitarism. Over replacement of these hormone agents is known to be harmful to the bone. We minimized the doses of L-thyroxine and hydrocortisone to achieve serum cortisol or free thyroxine levels within normal limits or slightly lower levels in all of cases. Second, a relatively small number of patients were analyzed in our study and the statistical power was relatively low. Third, serum testosterone levels increased during treatment but some patients still remained below the normal adult male range. Fourth, there are many factors associated with changes in BMD, such as diet, exercise, smoking, and alcohol. We were unable to collect these data from the medical chart review to include in our final analysis.

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Jenasteron steroids

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