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Vanderniet JA, Neville KA. Risk of transferability and variable absorption of topical testosterone creams in children and adolescents. J Paediatr Child Health 2024; 60:69-72. [PMID: 38534096 DOI: 10.1111/jpc.16532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 10/30/2023] [Accepted: 03/18/2024] [Indexed: 03/28/2024]
Affiliation(s)
- Joel A Vanderniet
- Department of Endocrinology, Sydney Children's Hospital, Sydney, New South Wales, Australia
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Kristen A Neville
- Department of Endocrinology, Sydney Children's Hospital, Sydney, New South Wales, Australia
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
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Wang X, Liao J, Nan Y, Hu J, Wu Y. Can testosterone modulate prosocial learning in healthy males? A double-blind, placebo-controlled, testosterone administration study. Biol Psychol 2023; 178:108524. [PMID: 36801356 DOI: 10.1016/j.biopsycho.2023.108524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 02/09/2023] [Accepted: 02/15/2023] [Indexed: 02/18/2023]
Abstract
Testosterone is associated with both aggressive and prosocial behavior, which depend on the social context and the trade-off between self- and other-interest. However, little is known about the effects of testosterone on prosocial behavior in a context without such trade-offs. The present study aimed to investigate the effects of exogenous testosterone on prosocial behavior by using a prosocial learning task. Healthy male participants (n =120) received a single dose of testosterone gel in a double-blind, placebo-controlled, between-participants experiment. Participants performed a prosocial learning task in which they were asked to learn to gain rewards for three different recipients, i.e., self, other and computer, by choosing symbols associated with potential rewards. The results showed that testosterone administration increased the learning rates across all the recipient conditions (dother = 1.57; dself = 0.50; dcomputer = 0.99). More importantly, participants in the testosterone group had a higher prosocial learning rate than those in the placebo group (d = 1.57). These findings suggest that testosterone generally enhances reward sensitivity and prosocial learning. The present study corroborates the social status hypothesis, according to which testosterone promotes status-seeking prosocial behavior when it is appropriate to the social context.
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Affiliation(s)
- Xin Wang
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong; School of Psychology, Shenzhen University, Shenzhen, China
| | - Jiajun Liao
- School of Psychology, South China Normal University, Guangzhou, China
| | - Yu Nan
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Jie Hu
- Zurich Center for Neuroeconomics, Department of Economics, University of Zurich, Switzerland
| | - Yin Wu
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong; Research Institute for Sports Science and Technology, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
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Abstract
All approved testosterone replacement methods, when used according to recommendations, can restore normal serum testosterone concentrations, and relieve symptoms in most hypogonadal men. Selection of the method depends on the patient's preference with advice from the physician. Dose adjustment is possible with most delivery methods but may not be necessary in all hypogonadal men. The use of hepatotoxic androgens must be avoided. Testosterone treatment induces reversible suppression of spermatogenesis; if fertility is desired in the near future, human chronic gonadotropin, selective estrogen receptor modulator, estrogen antagonist, or an aromatase inhibitor that stimulates endogenous testosterone production may be used.
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Affiliation(s)
- Christina Wang
- Division of Endocrinology, Clinical and Translational Science Institute, The Lundquist Institute at Harbor-UCLA Medical Center, Harbor-UCLA Medical Center, 1124 West Carson Street, Torrance, CA 90502, USA.
| | - Ronald S Swerdloff
- Division of Endocrinology, The Lundquist Institute and Harbor-UCLA Medical Center, 1124 West Carson Street, Torrance, CA 90502, USA
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4
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Salamin O, Nicoli R, Xu C, Boccard J, Rudaz S, Pitteloud N, Saugy M, Kuuranne T. Steroid profiling by UHPLC-MS/MS in dried blood spots collected from healthy women with and without testosterone gel administration. J Pharm Biomed Anal 2021; 204:114280. [PMID: 34340018 DOI: 10.1016/j.jpba.2021.114280] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/24/2021] [Accepted: 07/21/2021] [Indexed: 11/27/2022]
Abstract
The quantification of a large panel of endogenous steroids in serum by LC-MS/MS represents a powerful clinical tool for the screening or diagnosis of diverse endocrine disorders. This approach has also demonstrated excellent sensitivity for the detection of testosterone misuse in the anti-doping field, especially in female athlete population. In both situations, the use of dried blood spots (DBS) could provide a viable alternative to invasive venous blood collection. Here, the evaluation of DBS sampling for the quantification of a panel of endogenous steroids using UHPLC-MS/MS is described. The UHPLC-MS/MS method was validated for quantitative analysis of eleven free and eight conjugated steroids and was then used for the analysis of DBS samples collected in 14 healthy women during a normal menstrual cycle (control phase) followed by a 28-days testosterone gel treatment (treatment phase). Results were compared with those obtained from serum matrix. Satisfactory performance was obtained for all compounds in terms of selectivity, linearity, accuracy, precision, combined uncertainty, stability as well as extraction recovery and matrix effects. In control phase, high correlation was observed between DBS and serum concentrations for most compounds. In treatment phase, higher testosterone concentrations were observed in capillary than in venous DBS, suggesting a possible interference resulting from testosterone contamination on finger(s) used for gel application. Steroid profiling in capillary DBS represents a simple and efficient strategy for monitoring endogenous steroid concentrations and their fluctuation in clinical context of steroid-related disorders, or for the detection of testosterone abuse in anti-doping.
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Affiliation(s)
- Olivier Salamin
- Center of Research and Expertise in Anti-Doping Sciences - REDs, Institute of Sport Sciences, University of Lausanne, 1015, Lausanne, Switzerland; Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne and Geneva, Lausanne University Hospital and University of Lausanne, Switzerland.
| | - Raul Nicoli
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne and Geneva, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Cheng Xu
- Service of Endocrinology, Diabetology, and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Julien Boccard
- School of Pharmaceutical Sciences, University of Geneva, University Medical Centre, 1 Rue Michel-Servet, 1211, Geneva 4, Switzerland; Institute of Pharmaceutical Sciences of Western Switzerland (ISPSO), University of Geneva, Switzerland; Division of Biomedical and Metabolomic Analyses, Swiss Centre for Applied Human Toxicology (SCAHT), Basel, Switzerland
| | - Serge Rudaz
- School of Pharmaceutical Sciences, University of Geneva, University Medical Centre, 1 Rue Michel-Servet, 1211, Geneva 4, Switzerland; Institute of Pharmaceutical Sciences of Western Switzerland (ISPSO), University of Geneva, Switzerland; Division of Biomedical and Metabolomic Analyses, Swiss Centre for Applied Human Toxicology (SCAHT), Basel, Switzerland
| | - Nelly Pitteloud
- Service of Endocrinology, Diabetology, and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Martial Saugy
- Center of Research and Expertise in Anti-Doping Sciences - REDs, Institute of Sport Sciences, University of Lausanne, 1015, Lausanne, Switzerland
| | - Tiia Kuuranne
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne and Geneva, Lausanne University Hospital and University of Lausanne, Switzerland
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5
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Determination of anabolic steroids in dried blood using microsampling and gas chromatography-tandem mass spectrometry: Application to a testosterone gel administration study. J Chromatogr A 2020; 1628:461445. [DOI: 10.1016/j.chroma.2020.461445] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/28/2020] [Accepted: 07/31/2020] [Indexed: 12/18/2022]
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Yuen F, Wu S, Thirumalai A, Swerdloff RS, Page ST, Liu PY, Dart C, Wu H, Blithe DL, Sitruk-Ware R, Long J, Bai F, Hull L, Bremner WJ, Anawalt BD, Wang C. Preventing secondary exposure to women from men applying a novel nestorone/testosterone contraceptive gel. Andrology 2018; 7:235-243. [PMID: 30556332 DOI: 10.1111/andr.12577] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 11/07/2018] [Accepted: 11/27/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Testosterone (T)/Nestorone (NES) combination gel is a potential transdermal male contraceptive that suppresses gonadotropins and spermatogenesis. Transfer of transdermal T from men to women can be prevented by washing or covering application sites with clothing. OBJECTIVES We hypothesized that showering or wearing a shirt over gel application sites would prevent secondary exposure of T and NES to a woman after close skin contact. MATERIALS AND METHODS Twelve healthy male and 12 healthy female participants were recruited. Men applied T/NES 62 mg/8 mg gel to their shoulders and upper arms. Two hours after application, female partners rubbed the application site for 15 min. Exposure in the female partner was assessed under three conditions: a shirt covered the application site; the man showered prior to skin contact; or without intervention to reduce transfer. Serum T and NES concentrations were measured by LC-MS/MS in serial blood samples for 24 h after gel exposure. MAIN OUTCOMES Change in female serum T and NES levels as measured by average concentration over 24 h (Cavg ). RESULTS Median female serum T Cavg was 23.9 ng/dL (interquartile range, 19.3, 33.9) with the shirt barrier and 26.7 ng/dL (20.7, 33.9) after showering, which was higher than baseline 20.9 ng/dL (16.7, 25.0), both p < 0.03) but lower than without intervention (58.2 ng/dL [30.9, 89.1], both p < 0.01). Female serum NES Cavg and maximum concentration were below the lower limit of quantification with the shirt barrier and after showering, but increased without intervention in six of 12 women (maximum concentration <60 pg/mL). Men had lower average serum NES levels after showering (47 pg/ml [20, 94] compared to no intervention (153.3 pg/mL [51, 241], p < 0.02). CONCLUSION Secondary transfer of T and NES occurs after intensive skin contact with the gel application site. Secondary transfer is decreased by a shirt barrier or showering before contact.
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Affiliation(s)
- F Yuen
- Department of Medicine, Division of Endocrinology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - S Wu
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - A Thirumalai
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - R S Swerdloff
- Department of Medicine, Division of Endocrinology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - S T Page
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - P Y Liu
- Department of Medicine, Division of Endocrinology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - C Dart
- Health Decisions, Durham, NC, USA
| | - H Wu
- Health Decisions, Durham, NC, USA
| | - D L Blithe
- Contraceptive Development Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - R Sitruk-Ware
- Center for Biomedical Research, Population Council, New York, NY, USA
| | - J Long
- Contraceptive Development Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - F Bai
- Department of Medicine, Division of Endocrinology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - L Hull
- Department of Medicine, Division of Endocrinology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - W J Bremner
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - B D Anawalt
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - C Wang
- Department of Medicine, Division of Endocrinology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
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Satonin DK, Ni X, Mitchell MI, Joly H, Muram D, Small DS. Amount of Testosterone on Laundered Clothing After Use of Testosterone Topical 2% Solution by Healthy Male Volunteers. J Sex Med 2016; 13:187-93. [PMID: 26803453 DOI: 10.1016/j.jsxm.2015.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 12/10/2015] [Accepted: 12/13/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Testosterone 2% solution (Axiron) applied to armpit(s) is used for replacement therapy in men with a deficiency of endogenous testosterone. AIM To determine the amount of testosterone on subjects' T-shirts 12 hours after applying testosterone solution, the residual testosterone on subjects' T-shirts after laundering, and the testosterone transferred to unworn textile items during laundering with worn T-shirts. METHODS Healthy males ≥18 years old applied 2 × 1.5 mL of testosterone 2% solution to both axillae (total testosterone dose: 120 mg) and dressed in cotton long-sleeved T-shirts after a ≥3-minute waiting period. T-shirts were worn 12 hours before being removed and cut into halves, after which a 10 × 10 cm sample of each armpit area was excised for testosterone quantification before or after laundering with samples of unworn textiles. MAIN OUTCOME MEASURES Testosterone on worn T-shirts before and after laundering, and on unworn textiles laundered with the worn T-shirts. RESULTS Twelve subjects enrolled and completed, with only minor adverse events. Mean testosterone in unwashed worn T-shirts was 7603 μg, with high between-subject variability (3359 μg to 13,069 μg), representing 13% of the dose to 1 armpit. Mean testosterone in worn, laundered T-shirts was 260 μg (7.55 μg to 1343 μg), representing 3% of the dose to 1 armpit. Mean transferred testosterone to other textiles during laundering ranged from 69 μg on texturized Dacron 56T Double to 10,402 μg on 87/13 nylon/Lycra knit, representing 0.0382% to 5.78% of the dose to 1 armpit. CONCLUSION Thirteen percent of the testosterone applied to axillae was transferred to T-shirts during wear. Ninety-seven percent of the transferred testosterone was removed from the T-shirts during washing, some of which was then absorbed to various degrees by other textiles. Clinical implications of these findings and biological activity of the remaining/transferred testosterone are unknown.
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Affiliation(s)
- Darlene K Satonin
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA.
| | - Xiao Ni
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA
| | - Malcolm I Mitchell
- European Clinical Pharmacology, Eli Lilly and Company, Windlesham, United Kingdom
| | - Hellen Joly
- European Clinical Pharmacology, Eli Lilly and Company, Windlesham, United Kingdom
| | - David Muram
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA
| | - David S Small
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA
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Abstract
Dose adjustment with transdermal testosterone preparations should recognize the variability of serum total testosterone levels between applications and over the course of 24 h. Dose adjustments are also made difficult by between-laboratory assay variability. Low SHBG with obesity and diabetes lowers the total testosterone level, and free or bioavailable testosterone may prove to be a better choice for monitoring the progress and dosing of testosterone-treated men with adult onset hypogonadism.
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Pharmacokinetics and drying time of testosterone 2% gel in men with hypogonadism: a multicenter, open-label, single-arm trial. Int J Impot Res 2014; 27:41-5. [DOI: 10.1038/ijir.2014.28] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 05/19/2014] [Accepted: 06/06/2014] [Indexed: 11/08/2022]
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Cabrera SM, Rogol AD. Testosterone exposure in childhood: discerning pathology from physiology. Expert Opin Drug Saf 2013; 12:375-88. [DOI: 10.1517/14740338.2013.782000] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Corona G, Rastrelli G, Vignozzi L, Maggi M. Emerging medication for the treatment of male hypogonadism. Expert Opin Emerg Drugs 2012; 17:239-59. [DOI: 10.1517/14728214.2012.683411] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Miller MG, Rogol AD, Zumbrunnen TL. Secondary exposure to testosterone from patients receiving replacement therapy with transdermal testosterone gels. Curr Med Res Opin 2012; 28:267-9. [PMID: 22185432 DOI: 10.1185/03007995.2011.652255] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Stahlman J, Britto M, Fitzpatrick S, McWhirter C, Testino SA, Brennan JJ, Zumbrunnen TL. Serum testosterone levels in non-dosed females after secondary exposure to 1.62% testosterone gel: effects of clothing barrier on testosterone absorption. Curr Med Res Opin 2012; 28:291-301. [PMID: 22188558 DOI: 10.1185/03007995.2011.652732] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate secondary exposure of testosterone transferred to females from a male partner, dosed with 1.62% testosterone gel after direct skin-to-skin contact with the application site, and to investigate the effect of wearing a t-shirt on testosterone transfer. RESEARCH DESIGN AND METHODS Across three studies, a total of 72 healthy males applied 5.0 g 1.62% testosterone gel to their abdomen alone, upper arms/shoulders alone, or a combination of their upper arms/shoulders and abdomen (single dose or once daily for 7 days). Male-female contact occurred 2 or 12 hours after testosterone gel application, with males either wearing or not wearing a t-shirt. There were 15 minutes of supervised contact with the application site between the male and his female partner. Blood samples were collected over a 24 hour period in females for assessment of serum testosterone levels at baseline and after contact. MAIN OUTCOME MEASURES Pharmacokinetic parameters included C(max) (maximum serum concentration), AUC(0-24) (area under the serum concentration-time curve from 0-24 hours), and C(av) (time-averaged concentration over the 24-hour period post-contact). Subjects were monitored for adverse events. CLINICAL TRIAL REGISTRATION NCT NUMBERS: Study 1 was not registered (first subject enrolled 8 March 2007); Study 2: 00998933; Study 3, 01130298. RESULTS Testosterone levels (C(av) and C(max)) in females increased 86-185% from baseline after direct abdominal skin contact, although C(av) levels remained within female eugonadal range. Testosterone concentrations returned to baseline within 48 hours after last skin contact. A t-shirt barrier reduced testosterone transfer by approximately 40-48% when 5.0 g of testosterone gel was applied to the abdomen alone. A t-shirt barrier prevented transfer when 5.0 g of testosterone gel was applied to the upper arms and shoulders or to a combination of the upper arms and shoulders and the abdomen (C(max) and C(av) increased by approximately 5-11%). No major safety events were observed during the studies. CONCLUSIONS There is a risk of testosterone transfer from males using 1.62% testosterone gel to others who come in contact with the application site for at least 12 hours after application. Secondary exposure can be mitigated by means of a t-shirt barrier. STUDY LIMITATIONS Women for these studies were not selected by menopausal status. The study designs were intended to simulate exaggerated conditions of transfer.
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