A Practical Guide To Male Hypogonadism In The Primary Care Setting.
There is a high prevalence of hypogonadism in the middle- and older-aged male population and various prevalence figures have been described in a number of studies. A consistent feature of these studies is that hypogonadism increases with age. As the number of individuals aged 65 years and over in the US population is projected to rise from approximately 40 million (13.0%) in 2010 to approximately 60 million (17.9%) in 2025, the number of men, who presently comprise approximately 43% of this population, that are hypogonadal will also increase. As a result, physicians will be increasingly likely to encounter men with the symptoms of hypogonadism in the clinic.
The purpose of this review is to summarize the current understanding of male hypogonadism, with particular reference to the needs of the primary care physician. A key consideration for any physician is to understand the clinical significance of low testosterone levels and how hypogonadal men are likely to benefit from testosterone replacement therapy. It is also important to have a good understanding of the contraindications and risks associated with the therapy as well as the necessary treatment monitoring required.
Dandona P, Rosenberg MT. A practical guide to male hypogonadism in the primary care setting. Int J Clin Pract 2011;64(6):682-96. A practical guide to male hypogonadism in the primary care setting - Dandona - 2010 - International Journal of Clinical Practice - Wiley Online Library
There is a high prevalence of hypogonadism in the older adult male population and the proportion of older men in the population is projected to rise in the future. As hypogonadism increases with age and is significantly associated with various comorbidities such as obesity, type 2 diabetes, hypertension, osteoporosis and metabolic syndrome, the physician is increasingly likely to have to treat hypogonadism in the clinic. The main symptoms of hypogonadism are reduced libido/erectile dysfunction, reduced muscle mass and strength, increased adiposity, osteoporosis/low bone mass, depressed mood and fatigue. Diagnosis of the condition requires the presence of low serum testosterone levels and the presence of hypogonadal symptoms. There are a number of formulations available for testosterone therapy including intramuscular injections, transdermal patches, transdermal gels, buccal patches and subcutaneous pellets. These are efficacious in establishing eugonadal testosterone levels in the blood and relieving symptoms. Restoration of testosterone levels to the normal range improves libido, sexual function, and mood; reduces fat body mass; increases lean body mass; and improves bone mineral density. Testosterone treatment is contraindicated in subjects with prostate cancer or benign prostate hyperplasia and risks of treatment are perceived to be high by many physicians. These risks, however, are often exaggerated and should not outweigh the benefits of testosterone treatment.
There is a high prevalence of hypogonadism in the middle- and older-aged male population and various prevalence figures have been described in a number of studies. A consistent feature of these studies is that hypogonadism increases with age. As the number of individuals aged 65 years and over in the US population is projected to rise from approximately 40 million (13.0%) in 2010 to approximately 60 million (17.9%) in 2025, the number of men, who presently comprise approximately 43% of this population, that are hypogonadal will also increase. As a result, physicians will be increasingly likely to encounter men with the symptoms of hypogonadism in the clinic.
The purpose of this review is to summarize the current understanding of male hypogonadism, with particular reference to the needs of the primary care physician. A key consideration for any physician is to understand the clinical significance of low testosterone levels and how hypogonadal men are likely to benefit from testosterone replacement therapy. It is also important to have a good understanding of the contraindications and risks associated with the therapy as well as the necessary treatment monitoring required.
Dandona P, Rosenberg MT. A practical guide to male hypogonadism in the primary care setting. Int J Clin Pract 2011;64(6):682-96. A practical guide to male hypogonadism in the primary care setting - Dandona - 2010 - International Journal of Clinical Practice - Wiley Online Library
There is a high prevalence of hypogonadism in the older adult male population and the proportion of older men in the population is projected to rise in the future. As hypogonadism increases with age and is significantly associated with various comorbidities such as obesity, type 2 diabetes, hypertension, osteoporosis and metabolic syndrome, the physician is increasingly likely to have to treat hypogonadism in the clinic. The main symptoms of hypogonadism are reduced libido/erectile dysfunction, reduced muscle mass and strength, increased adiposity, osteoporosis/low bone mass, depressed mood and fatigue. Diagnosis of the condition requires the presence of low serum testosterone levels and the presence of hypogonadal symptoms. There are a number of formulations available for testosterone therapy including intramuscular injections, transdermal patches, transdermal gels, buccal patches and subcutaneous pellets. These are efficacious in establishing eugonadal testosterone levels in the blood and relieving symptoms. Restoration of testosterone levels to the normal range improves libido, sexual function, and mood; reduces fat body mass; increases lean body mass; and improves bone mineral density. Testosterone treatment is contraindicated in subjects with prostate cancer or benign prostate hyperplasia and risks of treatment are perceived to be high by many physicians. These risks, however, are often exaggerated and should not outweigh the benefits of testosterone treatment.