Aim. To assess the approaches to treatment of testosterone deficiency syndrome (TDS) in fertile (young) men with obesity.
Materials and methods. Comparative analysis of peculiarities of TDS correction in 120 men aged 21–35, suffering from class III abdominovisceral obesity, was performed taking into account the personified approach. Testosterone deficiency syndrome was detected in all the examined men. The examined patients were divided into two completely comparable groups: in group I, androgen replacement therapy was administered to patients, in group II – individual balanced diet, combined with individual physical loads and course of inhibitor of gastrointestinal lipases.
Results. In both groups, identical efficiency of TDS therapy in young men with obesity was established: when applying androgen replacement therapy and body mass decreasing therapy. However, the most favorable conditions for restoration of fertility are created when using complex multifactor therapy without testosterone preparations, since along with correction of erectile dysfunction, there is observed optimization of spermogram indices.
Conclusions. Differentiated approach to correction of testosterone deficiency syndrome among patients with obesity permits to optimize financial expenditure for treatment and preserve reproductive function. The body mass decrease leads to liquidation of testosterone deficiency syndrome, normalization of erectile function and lipid spectrum.