Diagnosing and managing androgen deficiency in men

Area of Science:

• Endocrinology
• Men's Health
• Metabolic Health

Background:

• Androgens are vital for bone, muscle, fat metabolism, erythropoiesis, and cognitive function.
• Hypogonadism affects 2.1-5.7% of men aged 40-79, presenting with symptoms like decreased libido, fatigue, and irritability.
• Obesity, type 2 diabetes, and metabolic syndrome are key factors impacting testosterone levels.

Purpose of the Study:

• To outline the clinical presentation and diagnosis of androgen deficiency in men.
• To identify factors and medications affecting testosterone levels.
• To describe the management and monitoring of testosterone replacement therapy.

Main Methods:

• Clinical history taking, focusing on presenting complaints and relevant medical history (obesity, diabetes, metabolic syndrome).
• Review of medications (statins, steroids, opioids) and substance use (alcohol, anabolic steroids, marihuana) impacting testosterone.
• Initiation of exogenous testosterone for persistent deficiency and regular follow-up monitoring.

Main Results:

• Androgen deficiency can be identified through presenting complaints or unrelated concerns.
• Numerous medical conditions and medications can lower testosterone levels.
• Testosterone replacement therapy requires a minimum of 3-6 weeks for symptom improvement.

Conclusions:

• Prompt identification and management of androgen deficiency are crucial for men's health.
• Comprehensive medical review and patient history are essential for diagnosis.
• Ongoing monitoring of testosterone, haematocrit, and PSA levels is necessary during testosterone replacement therapy.