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
Diagnosis of Hypogonadism i...
...Men with Suspected Hypogonadism...
...rine Society (ES) recommends diagnosing hyp...
...ning and Case Detection for Hyp...
...ends against routine screening of men in t...
...guishing Between Primary or Seconda...
...ho have hypogonadism, ES recommends...
...for Determining the Etiology of Hypogonadis...
...ypogonadism, ES suggests further evaluation to ide...
...1. Classification of Hypogonadism and Causes of P...
...able 2. Symptoms and Signs Suggestive of T Defici...
Table 3. Conditions in Which Measurement of FT...
...igure 1. An Approach for the Diagnostic...
Treatment
...eatment...
...reatment of Hypogonadism with...
...s testosterone therapy in hypogonadal men to...
...mmends against testosterone therapy in men plannin...
For patients who choose monitoring, clinicians s...
...hypogonadal men being considered for testo...
...Men with Age-Related Decline in Testosterone Con...
...sts against routinely prescribing testost...
...years who have symptoms or conditions...
...ed Men with Weight Loss...
...ggests that clinicians consider short-term testost...
...with Type 2 Diabetes M...
...ype 2 diabetes mellitus who have low testost...
...le 4. Conditions in Which T Administration Is Ass...
...able 5. Clinical Pharmacology of T Fo...
...stosterone Formulations Available Ou...
...otential Adverse Effects of T Repla...
Monitoring
...itoring...
...ing of Testosterone Replacement...
...al men who have started testosteron...
...mends a urological consultation for...
...Monitoring Men Receiving T TherapyHaving trouble...