Testosterone hormone replacement therapy

Testosterone Dihydro testosterone Hormone-replacement therapy in hypogonadal males... 

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. 

Finally, sex steroids are also implicated in the pathophysiology of depression. Estrogen deficiency states, which occur in the postpartum and postmenopausal periods, are thought to play a role in the etiology of depression in some women. Likewise, severe testosterone deficiency in men is sometimes associated with depressive symptoms. Hormone replacement therapy in hypogonadal men and women may be associated with an improvement in mood and depressive symptoms. 

The ability of androgens to counter osteoporosis is the basis of their use as a supplement to estrogens in one version of hormone replacement therapy. Testosterone can increase markers of bone formation (66). However, the early closure of epiphyses, with an arrest of growth, is a risk if children are exposed to these substances this latter effect may be produced by the estrogen to which testosterone is metabolized. In some patients with... 

Testosterone Undecanoate/ Restandol 40mg/Organon Laboratories/hormone replacement therapy... 

Oleic acid is the common name for (Z)-9-octadece-noic acid and is a nearly colorless liquid at room temperature with a melting point of 5-7°C. Oleic acid is practically insoluble in water but has been used as a solvent for oral delivery of hydrophobic drugs in soft gelatin capsules. Oleic acid is used to solubilize ritonavir in Norvir and Kaletra soft gelatin capsules (see section Microemulsion Oral Formulations ). Testosterone undecanoate is an ester prodrug of testosterone intended for oral administration in hormone replacement therapy, and is solubilized in oleic acid in 40 mg Restandol 40 mg soft gelatin capsules. 

Male hormone replacement therapy has been reviewed (11). Hypogonadism can be accompanied by hot flushes, similar to those seen in postmenopausal women, and gynecomastia. The potential risks of testosterone replacement in adult men are precipitation or worsening of sleep apnea, hastened onset of clinical significant prostate disease, benign prostatic hjrperplasia, prostatic carcinoma, gynecomastia, fluid retention, polycythemia, exacerbation of hypertension, edema, and an increased risk of cardiovascular disease. 

Another variant on hormone replacement therapy involves using aU three types of sex steroid in parallel, starting from the argument that during the fertile period all three are sjmthesized by the ovary (7). A natural version of this therapy uses estradiol, testosterone (with or without dehydroepiandrosterone), and progesterone in an appropriate pharmaceutical form (for example micro-nized), so that absorption is attained without the need for 17-substitution. This approach naturally avoids some of the undesirable effects of the synthetic steroids, and has been stated to improve menopausal depression and anxiety. However, the adverse effects of all three types of component can be experienced. 

Testosterone Undecanoate/ Restandol 40 mg/ Organon Laboratories/1981 CHjj H T ] Hormone replacement therapy 40-160 mg q.d. (1-4 capsules) Soft gelatin capsule 40 mg HSE (equivalents of testosterone, 61 mg of testosterone undecanoate Oleic acid Wholesaler in the refrigerator (2-8°C), and the patient at RT. Protect from light and heat. 

Oleic acid solubilizes 61 mg of testosterone undecanoate in Restandol 40 mg soft gelatin capsules. Testosterone undecanoate is an ester prodrug of testosterone intended for oral administration in hormone replacement therapy. Free testosterone is inactive following oral administration due to virtually complete hepatic first-pass extraction. However, the undecanoate ester prodrug is transported via the intestinal lymphatic system, thereby circumventing the hepatic portal circulation and the associated presystemic first-pass metabolism. The oral dose of testosterone undecanoate is 40-160 mg equivalents of testosterone (one to four capsules) once daily. Restandol 40 mg soft... 

HRT, Hormone replacement therapy. TRT, Testosterone replacement therapy. 

Testosterone is used in the form of esters such as its enanthate in hormone replacement therapy. The dmg is given in an oily injection and, because of its high degree of lipophilicity, it forms a depot in fatty tissue and thus... 

Teriparatide can be used if bisphosphonates are not tolerated or contraindicated. Testosterone replacement therapy should be considered in men, and high-dose hormonal oral contraceptives can be considered for premenopausal women with documented hypogonadism. 

Small quantities of progesterone, testosterone, and estradiol are also produced by the adrenal gland. However, they play a minor role compared to the testicular and ovarian hormones. Progesterone, which is the precursor of cortisol, aldosterone, testosterone, and estradiol, is synthesized from 5-pregnenolone by 3-P-ol-dehydrogenase. Deficiency of this enzyme results in cortisol and aldosterone deficiencies. Such patients require replacement therapy with both glucocorticoids and mineralocorticoids. 

Slowing the release of the parent steroid is a great benefit in steroid medicine, as free testosterone (or other steroid hormones) previously would remain active in the body for a very short period of time (typically hours). This would necessitate an unpleasant daily injection schedule if one wished to maintain a continuous elevation of testosterone (the goal of testosterone replacement therapy). By adding an ester, the patient can visit the doctor as infrequently as once per month for his injection, instead of having to constantly re-administer the drug to achieve a therapeutic effect. Clearly without the use of an ester, therapy with an injectable anabolic/androgen would be much more difficult. 

There are several disorders of the adrenal glands. Hypersecretion of aldosterone (Conn s syndrome) is treated with an aldosterone antagonist. Hypersecretion of cortisol (Cushing s syndrome) and testosterone (androgenital syndrome) are managed with surgery or irradiation. Hyposecretion of aldosterone and cortisol (Addison s disease) is life threatening and must be treated with replacement therapy of both hormones. 

By inducing anovulation with various hormonal therapies, the cyclicity of PMS disappears. Anovulation can be induced by estradiol implants, high doses of progesterones, OCs, GnRH-As, and danazol. For the perimenopausal syndrome, the replacement of hormones such as 17/S-estradiol, progesterone (if the uterus is intact), and testosterone is used to stabilize the deficiency and fluctuations in hormone levels. 

For drug therapy, native hormones have been replaced to a large extent by synthetic or semisynthetic derivatives that possess higher and more selective therapeutic potential. Some very important synthetic androgen analogs are the esters and the 17-methyl derivative of testosterone. Of the numerous related anabolic steroids, the esters of nandrolone (19-nortestosterone), methandienone (17a-methyl-17-hydroxy-l,4-androstadien-3-one), stanozolol (17a-methyl-2 H-5a-androst-2-eno[3,2-c]pyrazol-17-ol, and trenbolone acetate (17)S-hydroxy-4,9,ll-estratrien-3-one acetate) are most frequently used. 

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