Guide for assessing and treating testosterone deficiency in adult men

[madman]

Testosterone therapy improves various aspects of health, including sexual function, bone density, anemia, muscle mass, physical function, mood, and cognitive function, and reduces the risk of type 2 diabetes. It does not increase the risk of prostate cancer or cardiovascular problems. Evidence suggests potential cardiovascular benefits, especially for men with kidney disease, atrial fibrillation, or a history of heart attack. Long-term studies are needed for further clarification. Recent studies indicate that testosterone therapy, along with metformin, may reduce the occurrence of prostate and colorectal cancer.

 

[madman]

Figure 1. Clinical signs and symptoms suggestive of testosterone deficiency2,5–8

*It is important to ask about the loss of early morning erections even in men not in a sexual relationship, as absent early morning erections are an important predictor of future cardiovascular events.6

 

[madman]

Figure 2. BSSM Guidelines 2023. Diagnosing and managing testosterone deficiency in adult men.1 Reproduced from Hackett G, Kirby M, Rees R, et al. The British Society for Sexual Medicine Guidelines on Male Adult Testosterone Deficiency, With Statements for Practice. World J Mens Health 2023;41:e33.

Abbreviations: CVD, cardiovascular disease; DRE, digital rectal examination; ED, erectile dysfunction; FSH, follicle-stimulating hormone; FT, free testosterone; hCG, human chorionic gonadotropin; LH, luteinizing hormone; PDE5i, phosphodiesterase type 5 inhibitor; PSA, prostate-specific antigen; SHBG, sex-hormone-binding globulin; T2DM, type 2 diabetes mellitus; TD, testosterone deficiency; TT, total testosterone. *For men with TT levels <5.2nmol/L plus low LH and FSH or increased prolactin levels, refer to endocrinology or arrange a pituitary MRI to exclude a pituitary adenoma.2,17 t The T4DM study11 showed a 21% reduction in progression to T2DM by treating testosterone <14nmol/L in men with pre-diabetes

 

[madman]

Damn slim pickings!


Table 1. Current testosterone therapy options1

 

[madman]

Author-Provided Video​

A practical guide to the Assessment and Management of testosterone deficiency in adult men​

by Geoff Hackett and Mike Kirby

https://wchh.onlinelibrary.wiley.com/doi/full/10.1002/tre.914

 

[madman]

British Society for Sexual Medicine Guidelines on Male Adult TD

The British Society for Sexual Medicine Guidelines on Male Adult Testosterone Deficiency, With Statements for Practice (2023) Geoffrey Hackett, Michael Kirby, Rowland W. Rees, T. Hugh Jones, Asif Muneer, Mark Livingston, Nick Ossei-Gerning, Janine David, Jeff Foster, Philip A. Kalra, Sudarshan...

www.excelmale.com

 

[madman]

TRT and Cardiovascular Disease

Testosterone replacement therapy and cardiovascular disease (2022) Jeremy M. Auerbach and Mohit Khera The use of testosterone therapy has a complex history of apprehension and questions regarding its safety. Despite an eventual consensus that testosterone therapy was safe and effective...

www.excelmale.com

TRT and the Prostate

Testosterone Treatment and the Risk of Prostate Adverse Events (2022) Jason A. Levy, DO, MS, Arthur L. Burnett, MD, MBA, Adrian S. Dobs, MD, MHS INTRODUCTION Definition Hypogonadism is a clinical syndrome that results from failure of the testis to produce physiologic concentrations of...

www.excelmale.com

 

[Systemlord]

Damn slim pickings!


Table 1. Current testosterone therapy options1
View attachment 33499

Still stuck in the Stone Age I see. I find it insane that they describe the every 2-3 week injections -> short duration of action allows withdrawal in the event of side effects, however these protocols are causing the side effects.

Seems like a double edge sword.