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
...gnosis...
...s of Hypogonadism in Men...
...f Men with Suspected Hypogonadism...
...ine Society (ES) recommends diagnosing hypog...
...and Case Detection for Hypogonadism...
...ds against routine screening of men in the ge...
...Between Primary or Secondary Hypog...
...ave hypogonadism, ES recommends distinguishing b...
...valuation for Determining the Etiology of Hypo...
...ypogonadism, ES suggests further evalu...
...1. Classification of Hypogonadism and C...
...2. Symptoms and Signs Suggestive of T Defici...
.... Conditions in Which Measurement of...
...n Approach for the Diagnostic Eval...
Treatment
...reatment...
...of Hypogonadism with Testosterone
...estosterone therapy in hypogonadal men to...
...against testosterone therapy in me...
...or patients who choose monitoring, clinician...
...pogonadal men being considered for testoste...
...Age-Related Decline in Testosterone Concentr...
...suggests against routinely prescri...
...>65 years who have symptoms or conditions sug...
...fected Men with Weight Lo...
...that clinicians consider short-term testoster...
...ith Type 2 Diabetes Melli...
...men with type 2 diabetes mellitus who ha...
...tions in Which T Administration Is Assoc...
...e 5. Clinical Pharmacology of T Formulations...
...osterone Formulations Available Outside t...
.... Potential Adverse Effects of T Replaceme...
Monitoring
Monitorin...
...Testosterone Replacement Therapy...
In hypogonadal men who have started te...
...commends a urological consultation for hypo...
...Monitoring Men Receiving T TherapyHavi...