Testosterone Replacement Therapy

The staff of the Spinal Cord Damage Research Center (SCDRC), located at the Bronx VA Medical Center (VAMC), would like to introduce you to the first in a series of articles on research being performed on the consequences of spinal cord injury (SCI). The featured article this month is on testosterone replacement therapy in persons with chronic SCI.

The focus of research at the SCDRC is the secondary medical conditions associated with SCI. Injury of the spinal cord affects many systems of the body and causes widespread consequences, one of which is a reduction of circulating testosterone. Testosterone is a hormone largely responsible for the growth and development of masculine characteristics, as well as effects on mood and libido. Additionally, testosterone has a number of positive effects on muscles, bones, energy, and the cardiovascular system. Areas of health and wellness are linked to testosterone. Men with reduced levels could experience depression, fatigue and loss of motivation. These factors can have a direct effect on daily activities and quality of life for men with SCI.

United Spinal Association has supported the work of the SCDRC with Dr. William A. Bauman (Director) and his research staff. This work is being conducted at the Bronx VAMC and the two satellite centers-Helen Hayes Hospital in West Haverstraw, New York, and the Kessler Institute for Rehabilitation in West Orange, New Jersey-which permits wider subject participation in this clinical research.

For the past 15 years, United Spinal’s support of this research has permitted better understanding of the medical problems facing those with SCI, including the finding that men with SCI have lower levels of testosterone compared to their able-bodied peers. After SCI and immobilization, the body experiences adverse changes, including a reduction in metabolism and cardiovascular fitness, which may be worse if testosterone deficiency also occurs.

Currently, Spinal Cord Damage Research Center researchers Drs. Bauman and Jill M. Wecht and a collaborator from Kessler Institute for Rehabilitation, Dr. Steven Kirshblum, are exploring the role of testosterone replacement therapy in men with paraplegia. This ongoing study involves the participation of men, ages 18 to 65, who have paraplegia (thoracic SCI) for longer than one year.

Participants will be screened to see if they have normal or low testosterone levels. Those found to have low levels of testosterone will receive a daily testosterone patch for one year. Men with normal levels of testosterone (who will serve as controls and not receive a patch) as well as those who have low testosterone can participate in this study. Candidates must be in generally good health and not be using other bodybuilding drugs (anabolic steroids).

Based at the SDCRC, I will be responsible for the implementation of this project. Following the participants throughout their two-year enrollment, I will conduct most of the testing for this study and schedule follow-up visits. I will work in conjunction with the staff at Kessler, supporting this project and assisting with test procedures at the site as well.

The overall objective of the Spinal Cord Damage Research Center is to improve the quality of life and health for persons with SCI. Persons with SCI who are already enrolled, or who want to participate in research projects like this, may experience direct benefits-increased energy, greater strength, and improvements in general health-although these positive changes are not guaranteed, which is the reason for performing this study. Participation in such research projects is vital to increasing our knowledge and improving health care for persons with SCI and other disabilities.

For further information about this study and others, contact me in the SCDRC Human Performance Lab at 718-584-9000, ext. 3121.

Annemarie H. Krothe, MS, is Health Science Specialist and Research Coordinator at the Spinal Cord Damage Research Center of the Bronx VA Medical Center.