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- Title
TESTOSTERONE THERAPY IN MALE HYPOGONADISM A PROJECT GUIDELINE FOR ROMANIA.
- Authors
Mogos, Voichita
- Abstract
Male hypogonadism is a clinical syndrome that results from the inability of the testis to produce physiological levels of testosterone or a normal number of spermatozoa due to a dysfunction at one or more levels of the hypothalamus - pituitary - testis axis. Clinical presentation of male hypogonadism depends on the severity of testosterone deficiency and on the time of life when it occurs. The diagnosis of male hypogonadism is based on clinical examination, low total and free or bioavailable testosterone levels in the morning documented by repeated (at least twice) measurements. The etiology is established by determination of FSH, LH, prolactine, dynamic tests and other methods that are required in some cases. The goals of testosterone therapy in male hypogonadims are: to develop or to maintain secondary sexual characteristics, to improve sexual function, to improve muscle mass and strength, to improve bone mineral density and the quality of life. According to other guidelines, testosterone therapy is not recommended in men with breast cancer and prostate cancer. Prostate evaluation by digital rectal examination, PSA, and hematocrit determination are mandatory before starting testosterone therapy. The treatment will not be recommended in patients with prostate adenoma or PSA levels above 3 ng/dl without urological evaluation. Testosterone therapy will be not recommended in hypogonadal men presenting with conditions that could be worsened by the treatment such as erythrocytosis, untreated sleep apnea, severe prostatic hyperplasia symptoms and uncontrolled heart failure. The testosterone formulation will be chosen according to the patients' preference, pharmacokinetics, the availability and affordability of different formulations. The aim of the treatment is to maintain plasma testosterone levels into the mid-normal range for healthy adults. The monitoring of the therapy must be performed using the determination of testosterone, hematocrit and PSA levels, prostate examination, every 3 months in the first year and yearly thereafter. BMD determination will be performed at the beginning of the treatment and then at 2 year intervals. The author submits this project of guidelines for testosterone therapy to be improved by colleague endocrinologists according to their expertise.
- Publication
Acta Endocrinologica (1841-0987), 2007, Vol 3, Issue 2, p235
- ISSN
1841-0987
- Publication type
Academic Journal