Hypogonadism primary, treatment

DES is a synthetic estrogen that inhibits ovulation by affecting release of pituitary gonadotropins. Some of its uses include treatment for hypogonadism, primary ovarian... 

The estradiol transdermal system is indicated in the treatment of vasomotor symptoms associated with menopause. It is also used to treat female hypogonadism, primary ovarian failure, atrophic conditions (atrophic vaginitis or kraurosis vulvae), and in the prevention of osteoporosis (see Estrogen and Figure 48). 

Estrone or estropipate is used in the treatment of atrophic vaginitis and menopausal symptoms, female hypogonadism, primary ovarian failure, after castration, or in prostatic cancer (see also Figure 48). 

Hypoestrogenism caused by hypogonadism, castration, or primary ovarian failure-Treatment usually is initiated with a dose of 1 to 2 mg daily, adjusted as necessary to control presenting symptoms determine the minimal effective dose for maintenance therapy by titration. 

In women with an intact uterus for the treatment of moderate to severe vasomotor symptoms associated with menopause treatment of vulval and vaginal atrophy Femhrt and CHmaraPro excluded) osteoporosis prevention CombiPatch and ClimaraPro excluded) treatment of hypoestrogenism caused by hypogonadism, castration, or primary ovarian failure CombiPatch only). 

Replacement therapy - Replacement therapy in hypogonadism associated with a deficiency or absence of endogenous testosterone. Prior to puberty, androgen replacement therapy is needed for development of secondary sexual characteristics. Prolonged treatment is required to maintain sexual characteristics in these and other males who develop testosterone deficiency after puberty. Appropriate adrenal cortical and thyroid hormone replacement therapy are still necessary, however, and are of primary importance. 

Primary hypogonadism Estrogens have been used for replacement therapy in estrogen deficient patients (treatment of amenorrhoea). 

Erectile dysfunction must be distinguished from disorders of libido, ejaculatory disorders, or infertility, which are caused by different pathophysiologic mechanisms and are treated with alternative agents (Table 81-1). A patient may suffer from one or more disorders of sexual dysfunction. For example, an elderly man with primary hypogonadism may suffer from decreased libido and erectile dysfunction. Diagnosis of the type of sexual disorder that a patient has is a key to initiating the most appropriate treatment. 

Testosterone replacement regimens can be administered orally, parenterally, and topically (see Table 81-3). Injectable testosterone replacement regimens are preferred for treatment of symptomatic patients with primary or secondary hypogonadism because they are effective, inexpensive, and not associated with the bioavailability problems or hepatotoxic adverse effects of oral androgens. " Although convenient for the patient, testosterone patches and gels are much more expensive than other forms of androgen replacement therefore... 

It is indicated in the management of moderate to severe vasomotor symptoms associated with menopause treatment of atrophic vaginitis, kraurosis vulvae, fanale hypogonadism, symptoms of female castration, and primary ovarian failure prevention and treatment of osteoporosis (conjugated estrogens) palliative treatment of metastatic breast or prostate cancer in selected women and men treatment of postpartum breast engorgement and abnormal uterine bleeding. 

Quinestrol (100 meg daily for 7 days), which mimics the action of endogenous estrogen, is indicated for the treatment of moderate to severe vasomotor symptoms associated with menopause, atrophic vaginitis, kraurosis vulvae, female hypogonadism, female castration, and primary ovarian failures. Quinestrol is stored in body fat, slowly released over several days, and metabolized to ethinyl estradiol. 

Teriparatide is a parathyroid hormone, which regulates bone metabolism, renal tubular reabsorption of calcium and phosphate, and intestinal calcium reabsorption. It is indicated in the treatment of postmenopausal women with osteoporosis who are at high risk for fracture (e.g., history of osteoporotic fracture) and to increase bone mass in men with primary or hypogonadal osteoporosis who are at high risk of fracture (e.g., history of osteoporotic fracture). 

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