Male hypogonadism and its treatment
Authors:
Václav Hána; Mikuláš Kosák; Václav Hána jr.
Authors‘ workplace:
3. interní klinika – klinika endokrinologie a metabolismu 1. LF UK a VFN v Praze
Published in:
Čas. Lék. čes. 2017; 156: 258-265
Category:
Review Article
Overview
Male hypogonadism can be of various etiology and that reflects its clinical manifestation, diagnostics and treatment. Male hypogonadism leads not only to decreased fertility, but influences the cardiovascular system, mood changes, bone fragility, lipids and other metabolic functions. Diagnosis of hypogonadism can be cumbersome, as well as the choice of optimal hormonal supplementation. The aim of this article is to summarize the basics from symptoms, diagnosis and treatment of male hypogonadism.
Keywords:
male hypogonadism, testosterone, infertility
Sources
1. Zarotsky V, Huang MY, Carman W et al. Systematic literature review of the risk factors comorbidities and consequences of hypogonadism in men. Andrology 2014; 2(6): 819–834.
2. Bhasin S, Cunningham GR, Hayes FJ et al. Testosterone therapy in men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2010; 95(6): 2536–2559.
3. Baillargeon J, Urban RJ, Ottenbacher KJ et al. Trends in androgen prescribing in the United States 2001 to 2011. JAMA Intern Med 2013; 173(15): 1465–1466.
4. Mihalca R, Fica S. The impact of obesity on the male reproductive axis. J Med Life 2014; 7(2): 296–300.
5. Tajar A, Huhtaniemi IT, O’Neill TW et al. Characteristics of androgen deficiency in late-onset hypogonadism: results from the European Male Aging Study (EMAS). J Clin Endocrinol Metab 2012; 97: 1508 –1516.
6. Wang C, Nieschlag E, Swerdloff R et al. Investigation treatment and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA and ASA recommendations. Eur J Endocrinol 2008; 159(5): 507–514.
7. Diver MJ. Analytical and physiological factors affecting the interpretation of serum testosterone concentration in men. Ann Clin Biochem 2006; 43(Pt. 1): 3–12.
8. Mohr BA, Guay AT, O’Donnell AB, McKinlay JB. Normal bound and nonbound testosterone levels in normally ageing men: results from the Massachusetts Male Ageing Study. Clin Endocrinol (Oxf) 2005; 62(1): 64–73.
9. Vermeulen A, Verdonck L, Kaufman JM. A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab 1999; 84: 3666–3672.
10. Nanjee MN, Wheeler MJ. Plasma free testosterone – is an index sufficient? Ann Clin Biochem 1985; 22(Pt. 4): 387–390.
11. Grigorova M, Punab M, Zilaitienė B et al. Genetically determined dosage of follicle-stimulating hormone (FSH) affects male reproductive parameters. J Clin Endocrinol Metab 2011; 96(9): E1534–E1541.
12. Tüttelmann F, Laan M, Grigorova M et al. Combined effects of the variants FSHB -211G>T and FSHR 2039A>G on male reproductive parameters. J Clin Endocrinol Metab 2012; 97(10): 3639–3647.
13. Ferlin A, Vinanzi C, Selice R et al. Toward a pharmacogenetic approach to male infertility: polymorphism of follicle-stimulating hormone beta-subunit promoter. Fertil Steril 2011; 96(6): 1344–1349.
14. Selice R, Garolla A, Pengo M et al. The response to FSH treatment in oligozoospermic men depends on FSH receptor gene polymorphisms. Int J Androl 2011; 34(4): 306–312.
15. Liu PY, Baker HW, Jayadev V et al. Induction of spermatogenesis and fertility during gonadotropin treatment of gonadotropin-deficient infertile men: predictors of fertility outcome. J Clin Endocrinol Metab 2009; 94(3): 801–808.
16. Dwyer AA, Sykiotis GP, Hayes FJ et al. Trial of recombinant follicle-stimulating hormone pretreatment for GnRH-induced fertility in patients with congenital hypogonadotropic hypogonadism. J Clin Endocrinol Metab 2013; 98(11): E1790–E1795.
17. Chua ME, Escusa KG, Luna S et al. Revisiting oestrogen antagonists (clomiphene or tamoxifen) as medical empiric therapy for idiopathic male infertility: a meta-analysis. Andrology 2013; 1(5): 749–757.
18. Anawalt BD. Approach to male infertility and induction of spermatogenesis. J Clin Endocrinol Metab 2013; 98(9): 3532–3542.
19. Roth MY, Amory JK, Page ST. Treatment of male infertility secondary to morbid obesity. Nat Clin Pract Endocrinol Metab 2008; 4(7): 415–419.
20. Barrett-Connor EL. Testosterone and risk factors for cardiovascular disease in men. Diabetes Metab 1995; 21(3): 156–161.
21. Khaw KT, Barrett-Connor E. Blood pressure and endogenous testosterone in men: an inverse relationship. J Hypertens 1988; 6(4): 329–332.
22. Araujo AB, Dixon JM, Suarez EA et al. Clinical review: Endogenous testosterone and mortality in men: a systematic review and meta-analysis. J Clin Endocrinol Metab 2011; 96(10): 3007–3019.
23. Vigen R, O’Donnell CI, Barón AE et al. Association of testosterone therapy with mortality myocardial infarction and stroke in men with low testosterone levels. JAMA 2013; 310(17): 1829–1836.
24. Finkle WD, Greenland S, Ridgeway GK et al. Increased risk of non-fatal myocardial infarction following testosterone therapy prescription in men. PloS One 2014; 9(1): e85805.
25. Basaria S, Coviello AD, Travison TG et al. Adverse events associated with testosterone administration. N Engl J Med 2010; 363(2): 109–122.
26. Xu L, Freeman G, Cowling BJ, Schooling CM. Testosterone therapy and cardiovascular events among men: a systematic review and meta-analysis of placebo-controlled randomized trials. BMC Med 2013; 11: 108.
27. Morgentaler A, Miner MM, Caliber M et al. Testosterone therapy and cardiovascular risk: advances and controversies. Mayo Clin Proc 2015; 90(2): 224–251.
28. Shores MM, Smith NL, Forsberg CW et al. Testosterone treatment and mortality in men with low testosterone levels. J Clin Endocrinol Metab 2012; 97: 2050–2058.
29. Cheetham TC, An J, Jacobsen SJ et al. Association of testosterone replacement with cardiovascular outcomes among men with androgen deficiency. JAMA Intern Med 2017; 177(4): 491–499.
30. Fernandez-Balsells MM, Murad MH, Lane M et al. Clinical review 1: adverse effects of testosterone therapy in adult men: a systematic review and meta-analysis. J Clin Endocrinol Metab 2010; 95: 2560–2575.
31. Loughlin KR, Richie JP. Prostate cancer after exogenous testosterone treatment for impotence. J Urol 1997; 157: 1845.
32. Ohlander SJ, Varghese B, Pastuszak AW. Erythrocytosis following testosterone therapy. Sex Med Rev 2017 May 16, S2050-0521(17)30041-0, doi: 10.1016/j.sxmr.2017.04.001.
33. Zitzmann M, Nieschlag E. Androgen receptor gene CAG repeat length and body mass index modulate the safety of long-term intramuscular testosterone undecanoate therapy in hypogonadal men. J Clin Endocrinol Metab 2007; 92(10): 3844–3853.
34. Corona G, Maseroli E, Rastrelli G et al. Cardiovascular risk associated with testosterone-boosting medications: a systematic review and meta-analysis. Expert Opin Drug Saf 2014; 13(10): 1327–1351.
35. Calof OM, Singh AB, Lee ML et al. Adverse events associated with testosterone replacement in middle-aged and older men: a meta-analysis of randomized placebo-controlled trials. J Gerontol A Biol Sci Med Sci 2005; 60: 1451–1457.
36. Hána V. Endokrinologie pro praxi. Maxdorf, Praha, 2014.
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Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental HygienistArticle was published in
Journal of Czech Physicians
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