Testosterone therapy

Testosterone therapy may be indicated for the treatment of erectile dysfunction in which of the following situations ... 

The adverse effects of long-term testosterone therapy in HIV-positive men are irritability, weight gain, fatigue, hair loss, reduced volume of ejaculate, testicular atrophy, truncal acne, breast tenderness, and increased aggression... 

Maguen S, Wagner GJ, Rabkin JG. Long-term testosterone therapy in HTV-positive men side-effects and maintenance of clinical benefit. AIDS 1998 12(3) 327-8. 

Siddique H, Smith JC, Corrall RJM. Reversal of poly-cythaemia induced by intramuscular androgen replacement using transdermal testosterone therapy. Clin Endocrinol 2004 60 143-5. 

Kong A, Edmonds P. Testosterone therapy in HIV wasting syndrome systematic review and metaanalysis. Lancet Infect Dis. 2002 2 692-699. 

Reddy P, Guzman A, Robalino J, Shevde K. Resistance to muscle relaxants in a patient receiving prolonged testosterone therapy. Anesthesiology 1989 70(5) 871-3. 

Oettel M (2003) Testosterone metabolism, dose-response relationships and receptor polymorphisms Selected pharmacological/toxicological considerations on benefits versus risks of testosterone therapy in men. Aging Male 6 230-256. 

Middle-aged women with somatic and mood symptoms shonld undergo evaluation for perimenopansal depression. Transdermal 17/3-estradiol replacement can rednce vasomotor symptoms significantly improve mood, sleep, and cognition and decrease the risk of osteoporosis. " Transdermal testosterone therapy has been shown to improve mood, well-being, and sexnal fnnctioning in perimenopansal women. ... 

Goldstat R, Briganti E, Tran J, et al. Transdermal testosterone therapy improves well-being, mood, and sexual function in premenopausal women. Menopause 2003 10 390-398. 

Nonetheless, oral testosterone therapy can decrease HDL cholesterol and apolipoprotein Aj and also can lower triglycerides. However, exogenous testosterone therapy increases brachial artery flow-mediated vasodilation and the vasodilation induced by glyceryl trinitrate in postmenopausal women stabilized on hormone therapy. ... 

Relative contraindications to testosterone therapy include moderate to severe acne, clinical hirsutism, and androgenic alopecia. Absolute contraindications to androgen replacement include pregnancy or lactation and known or suspected androgen-dependent neoplasia. 

Worboys S, Kotsopoulos D, Teede H, et al. Evidence that parenteral testosterone therapy may improve endothehum-dependent and -independent vasodilation in postmenopausal women already receiving estrogen. J Clin Endocrinol Metab 2001 86 158-161. 

Jockenhovel, F. (2004) Testosterone therapy - what, when and to whom Aging Male, 7, 319-324. 

The goal of testosterone therapy in hypogonadal men is to mimic as closely as possible the normal serum concentration therefore, serum testosterone concentration must be monitored. With transdermal patches, the serum testosterone concentration fluctuates during the 24-hour period, with a peak value 6—9 hours after application and a nadir (about 50% of the peak) just before the next patch is applied (Figure 58-6). With testosterone gels, the mean serum testosterone concentration is relatively constant from one application to the next. Occasional random fluctuations can occur, so measurements should be repeated for any dose. When the enanthate or cypionate esters of testosterone are administered once every 2 weeks (typically in a dose of200 mg), the serum testosterone concentration measured midway between doses should be normal if not, the dose should be adjusted accordingly. 

Testosterone therapy may help increase your sperm count. ... 

We also found in this study that castrated short-photoperiod males treated with both testosterone and prolactin displayed a preference for the scent of long-photoperiod intact males (X SE, 7.0 1.5 seconds Wilcoxon matched-pairs test, P < 0.006) over the scent of long-photoperiod intact females (4.1 1.0 seconds). However, no significant preference was exhibited when the same male subjects were allowed to choose between the scents of short-photoperiod intact males (6.4 1.2 seconds P> 0.492, ns) and short-photoperiod intact females (7.5 2.0 seconds). Thus, our second hypothesis was not supported since prolactin therapy and testosterone therapy are not sufficient to induce castrated short-photoperiod males to display a preference for long-photoperiod female odor (Leonard Ferkin, unpublished data). 

Observational studies The risks of testosterone therapy in men are poorly understood. In an extensive meta-analysis of data from 51 selected studies testosterone treatment was found to be associated with significant increases in hemoglobin (mean 0.80 g/dl) and hematocrit (mean 3.2%) and a reduction in high-density lipoprotein cholesterol (mean —0.01 mmol/1) [42 ]. There were no significant effects on mortality or prostate or cardiovascular outcomes. The authors stressed that these findings are of unknown clinical significance. Current evidence about the safety of testosterone treatment in men in terms of patient-important outcomes is of low quality and is hampered by the fact that follow-up is generally brief. 

Cardiovascular In a study in older men with limited mobility and a high prevalence of chronic diseases, the use of testosterone gel was associated with an increased risk of cardiovascular adverse events [43 ]. However, the small size of the trial and the particular nature of the population studied prevented broader inferences from being made about the safety of testosterone therapy. 

Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS, Montori VM. Testosterone therapy in men with androgen deficiency syndromes an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2010 95 2536-59. 

Fernandez-Balsells MM, Murad MH, Lane M, Lampropulos JF, Albuquerque F, Mullan RJ, Agrwal N, Elamin MB, Gallegos-Orozco JF, Wang AT, Erwin PJ, Bhasin S, Montori VM. Adverse effects of testosterone therapy in adult men. A systematic review and meta-analysis. J Clin Endocrinol Metab 2010 95 2560-75. 

Shabsigh R, Crawford ED, Nehra A, Slawin KM. Testosterone therapy in hypo-gonadal men and potential prostate cancer risk a systematic review. Int J Impot Res 2009 21 9-23. 

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