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
...Diagnosi...
...Diagnosis o...
...Diagnosis of Men with Su...
...ocrine Society (ES) recommends diagnosing...
...Screening and Cas...
...nds against routine screening of men in...
...Distinguishing Between...
...men who have hypogonadism, ES recommends...
...Evaluation fo...
...with hypogonadism, ES suggests furthe...
...Classification of Hypogonadism and Causes of...
...e 2. Symptoms and Signs Suggestive of T Defi...
...Conditions in Which Measurement of FT Con...
...proach for the Diagnostic Evaluation of Adult Me...
Treatment
...Treatment of Hypogon...
...testosterone therapy in hypogonadal men to in...
...ends against testosterone therapy in me...
...patients who choose monitoring, clinicians sh...
...pogonadal men being considered for testos...
...Older Men with A...
...suggests against routinely prescr...
...>65 years who have symptoms or conditions sugge...
...HIV-Infected M...
...that clinicians consider short-term testosteron...
...Men with T...
...with type 2 diabetes mellitus who have low testost...
...4. Conditions in Which T Administrati...
...linical Pharmacology of T Formulatio...
...Testosterone Formulations Available Outside...
...le 7. Potential Adverse Effects of T Replaceme...
Monitoring
...Monitoring...
M...
...men who have started testosterone th...
...a urological consultation for hypogonadal men rec...
...able 8. Monitoring Men Receiving T Therapy...