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Multidisciplinary Insights Into the Assessment

, Diagnosis, and Management of Hypogonadism

Hypogonadism is associated with comorbid conditions, including depression, ED, increased BMI and waist circumference, type 2 diabetes, metabolic syndrome, coronary artery disease, and other chronic illnesses. All of these are routinely seen by primary care clinicians, which highlights the importance for physicians to be aware of how testosterone levels can be related to and affected by these conditions.

A variety of safe, effective formulations of testosterone are available. As clinicians and patients become more aware of this

condition and how to properly diagnosis and treat it, the number of testosterone prescriptions is expected to rise. The medical community is increasingly treating testosterone deficiency (not aging), as highlighted by Andre T. Gua , MD, Director of the Center for Sexual Function, Lahey Clinic Northshore, and Clinical Assistant Professor of Medicine (Endocrinology) at Harvard Medical School in Boston, Massachusetts. Prostate health should be assessed at baseline and periodically during treatment. Treatment goals should be to resolve signs and symptoms of hypogonadism and improve the patient’s quality of life.

REFERENCES

1. Rhoden EL, Morgentaler A. Risks of testosterone-replacement therapy and recommendations for monitoring [review]. N Engl J Med. 2004;350(5):482-492.

12. Rhoden EL, Ribeiro E , Teloken C, Souto CA. Diabetes mellitus is associated with subnormal serum levels of free testosterone in men. BJU Int. 2005;96(6):867-870.

  • 2.

    Alliance for Aging Research. Low testosterone—men’s health condition in the shadows: survey highlights. Alliance for Aging Research Web site. http://www.agingresearch.org/content/article/detail/714/. Accessed August 1, 2008.

  • 3.

    Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR. Longitudinal effects of aging on serum total and free testosterone levels in health men. J Clin Endocrinol Metab. 2001;86(2):724-731.

  • 4.

    Feldman HA, Longcope C, Derby CA, et al. Age trends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts Male Aging Study. J Clin Endocrinol Metab. 2002;87(2):589-598.

  • 5.

    Araujo AB, Esche GR, Kupelian V, et al. Prevalence of symptomatic androgen deficiency in men. J Clin Endocrinol Metab. 2007;92(11):4241-4247.

  • 6.

    Mulligan T, Frick MF, Zuraw QC, Stemhagen A, McWhirter C. Prevalence of hypogonadism in males aged at least 45 years: the HIM study. Int J Clin Pract. 2006;60(7):762-769.

  • 7.

    Sadovsky R, Dhindsa S, Margo K. Testosterone deficiency: which patients should you screen and treat? J Fam Pract. 2007;56(5 suppl):S3-S20.

  • 8.

    Mooradian AD, Morley JE, Korenman SG. Biological actions of androgens. Endocr Rev. 1987;8(1):1-28.

  • 9.

    Snyder PJ. Hypogonadism in eldery men—what to do until the evidence comes. N Engl J Med. 2004;350(5):440-442.

10. Kaufman JM, Vermeulen A. The decline of androgen levels in elderly men and its clinical and therapeutic implications. Endocr Rev. 2005;26(6):833-876.

  • 13.

    Isidori AM, Caprio M, Strollo F, et al. Leptin and androgens in male obesity: evidence for leptin contribution to reduced androgen levels. J Clin Endocrinol Metab. 1999;84(10):3673-3680.

  • 14.

    Kapoor D, Aldred H, Clark S, Channer KS, Jones TH. Clinical and biochemical assessment of hypogonadism in men with type 2 diabetes: correlations with bioavailable testosterone and visceral adiposity. Diabetes Care. 2007;30(4):911-917.

  • 15.

    Muller M, Grobbee DE, den Tonkelaar I, Lamberts SWJ, van der Schouw YT. Endogenous sex hormones and metabolic syndrome in aging men. J Clin Endocrinol Metab. 2005;90(5):2618-2623.

  • 16.

    Kupelian V, Page ST, Araujo AB, Travison TG, Bremner WJ, McKinlay JB. Low sex hormone-binding globulin, total testosterone, and symptomatic androgen deficiency are associated with development of the metabolic syndrome in nonobese men. J Clin Endocrinol Metab. 2006;91(3):843-850.

  • 17.

    Makhsida N, Shah J, Yan G, Fisch H, Shabsigh R. Hypogonadism and metabolic syndrome: implications for testosterone therapy. J Urol. 2005;174(3):827-834.

  • 18.

    Barrett-Connor E, von Mühlen DG, Kritz-Silverstein D. Bioavailable testosterone and depressed mood in older men: the Rancho Bernardo Study. J Clin Endocrinol Metab. 1999;84(2):573-577.

  • 19.

    Shores MM, Matsumoto AM, Sloan KL, Kivlahan DR. Low serum testosterone and mortality in male veterans. Arch Intern Med. 2006;166(15):1660-1665.

  • 20.

    Laughlin GA, Barrett-Connor E, Bergstrom J. Low serum testosterone and mortality in older men. J Clin Endocrinol Metab. 2008;93(1):68-75.

11. Tenover JL. Male hormone replacement therapy including “andropause. Endocrinol Metab Clin North Am. 1998;27(4):969-987, x.

21. Carnegie C. Diagnosis of hypogonadism: clinical assessments and laboratory tests. Rev Urol. 2004;6(suppl 6):S3-S8.

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