Sunday, October 05, 2008 Dumaguing: Treatment of male hypogonadism By Dr. Victor Dumaguing To Your Health
IT IS estimated that hypogonadism, also known as low testosterone, affects more than 13 million men in the United States aged 45 and older.
Because signs and symptoms of low testosterone are subtle and often overlap with other common medical conditions, low testosterone is frequently undiagnosed.
Signs and symptoms of low testosterone include low sex drive, erectile dysfunction, fatigue, depressed mood, reduced muscle mass and strength, increased fat body mass and decreased bone mineral density.
Men with chronic conditions, such as obesity, diabetes, high blood pressure, high cholesterol and asthma/COPD, are also more likely to have low testosterone compared to other men.
Below normal levels of testosterone can be confirmed by a blood test.
Testosterone treatment is designed to elevate a hypogonadal male's testosterone levels into the normal physiologic range, which may alleviate symptoms related to low testosterone. As with any medication, patients should work with their physician to weigh treatment benefits and risks.
AndroGel, the first US Food and Drug Administration (FDA) approved testosterone gel available in a non-aerosol, metered-dose pump, is a once-daily, clear, odorless topical testosterone gel approved in 2000 for replacement therapy in men ages 18 and older for conditions associated with a deficiency or absence of endogenous testosterone. AndroGel is the most prescribed form of testosterone therapy for adult males in the United States.
Pivotal data showed that AndroGel was effective in restoring testosterone levels to normal and in some cases, superior to a transdermal testosterone patch.
* AndroGel was effective in improving sexual function, mood and muscle strength increasing lean body mass; and decreasing body fat.
* It was demonstrated that AndroGel was more effective than a testosterone patch in increasing lean body mass and decreasing body fat, and had comparable effects with other symptoms.
* Because of minimal skin irritation, subject using AndroGel also had higher compliance rates.
* In a 2004 open-label, follow-up extension study, AndroGel was shown to be safe for men to use over the long term.
The AndroGel pump is designed to deliver 1.25 grams of testosterone gel per pump depression, and it is also available in 2.5 and 5 gram packets. This gives patients two convenient ways to use AndroGel and offers physicians added flexibility to move, if necessary, from the starting dose of 5g per day to 7.5 g or from 7.5g to 10g per day.
AndroGel must not be used if you have known or suspected prostate cancer or breast cancer (a rare condition for men). It must not be used by women who are pregnant, may become pregnant, or breastfeeding, as testosterone may cause fetal harm.
The major risks of AndroGel include prostate enlargement, prostate cancer, and transfer of testosterone to others (including women and children). Transference can occur when vigorous skin-to-skin contact is made with the application site and can be minimized by washing your hands after application and covering the application site with clothing.
The most common adverse events reported are skin irritation where gel is applied, breast development or tenderness, acne, prostate enlargement, changes in lab test results and changes in urinary habits.
