Testosterone Therapy in Men With Hypogonadism
Key Points
Key Points
- Hypogonadism is a clinical syndrome that results from failure of the testis to produce physiological concentrations of testosterone (T deficiency) and/or a normal number of spermatozoa due to pathology at one or more concentrations of the hypothalamic-pituitary-testicular axis.
- Testosterone (T) deficiency can be due to testicular defects (primary hypogonadism), hypothalamus-pituitary defects (secondary hypogonadism) or both.
- Primary hypogonadism results in low T concentrations, impairment of spermatogenesis, and elevated gonadotropin levels. The causes of primary hypogonadism are listed in Table 1.
- Secondary hypogonadism results in low T concentrations, impairment of spermatogenesis, and low or inappropriately normal gonadotropin levels. Causes of secondary hypogonadism are listed in Table 1.
- Combined primary and secondary hypogonadism results in low T concentrations, impairment of spermatogenesis, and variable gonadotropin levels.
- Additionally, the process of evaluating secondary hypogonadism may uncover a deficiency/excess of other pituitary hormones or a hypothalamic or pituitary tumor that may require management in addition to treating hypogonadism
Diagnosis
...Diagnosis...
...D...
...Diagnosis of...
...ndocrine Society (ES) recommends diagnosi...
...ommends against routine screening of me...
...Distinguishin...
...en who have hypogonadism, ES recommends distingui...
...Evaluatio...
...ypogonadism, ES suggests further evalua...
...e 1. Classification of Hypogonadism and Causes of...
...s and Signs Suggestive of T Deficiency in MenHa...
...ions in Which Measurement of FT Co...
...Approach for the Diagnostic Evaluation of Adult M...
Treatment
...Treatment...
...Treatment of Hyp...
...commends testosterone therapy in hypogon...
...ecommends against testosterone therapy in men p...
...ients who choose monitoring, clinicians s...
...hypogonadal men being considered for te...
...Older...
...ts against routinely prescribing test...
...years who have symptoms or conditions suggestive...
...HIV-Infected Men with We...
...at clinicians consider short-term testosterone the...
...Men with Type...
...h type 2 diabetes mellitus who have...
...le 4. Conditions in Which T Administration...
...inical Pharmacology of T Formulations Approve...
...e 6. Testosterone Formulations Available Outside...
...able 7. Potential Adverse Effects of...
Monitoring
...M...
...Monitoring of T...
In hypogonadal men who have started testosteron...
...ommends a urological consultation for hypogonad...
...8. Monitoring Men Receiving T TherapyHaving trou...