Disclosures Paresh Dandona is supported by grants from NIH (5R01DK069805-02) and American Diabetes Association. He also receives grant support from Merck, Solvay, Sanofi-Aventis and Amylin – Eli Lilly Pharmaceuticals. He receives honoraria from these companies and GlaxoSmithKline. Matt T. Rosenberg is an advisor/consultant for Solvay, ENDO, GSK, Astellas, Allergan, Bayer, Ortho MacNeil, Sanofi, and Watson. He is also a speaker for GSK, Astellas, Allergan, Bayer, Ortho MacNeil, Pfizer, and Watson.
A practical guide to male hypogonadism in the primary care setting
Article first published online: 9 APR 2010
© 2010 Blackwell Publishing Ltd
International Journal of Clinical Practice
Volume 64, Issue 6, pages 682–696, May 2010
How to Cite
Dandona, P. and Rosenberg, M. T. (2010), A practical guide to male hypogonadism in the primary care setting. International Journal of Clinical Practice, 64: 682–696. doi: 10.1111/j.1742-1241.2010.02355.x
Re-use of this article is permitted in accordance with the Terms and Conditions set out at http://www3.interscience.wiley.com/authorresources/onlineopen.html
- Issue published online: 9 APR 2010
- Article first published online: 9 APR 2010
- Paper received September 2009, accepted January 2010
There is a high prevalence of hypogonadism in the older adult male population and the proportion of older men in the population is projected to rise in the future. As hypogonadism increases with age and is significantly associated with various comorbidities such as obesity, type 2 diabetes, hypertension, osteoporosis and metabolic syndrome, the physician is increasingly likely to have to treat hypogonadism in the clinic. The main symptoms of hypogonadism are reduced libido/erectile dysfunction, reduced muscle mass and strength, increased adiposity, osteoporosis/low bone mass, depressed mood and fatigue. Diagnosis of the condition requires the presence of low serum testosterone levels and the presence of hypogonadal symptoms. There are a number of formulations available for testosterone therapy including intramuscular injections, transdermal patches, transdermal gels, buccal patches and subcutaneous pellets. These are efficacious in establishing eugonadal testosterone levels in the blood and relieving symptoms. Restoration of testosterone levels to the normal range improves libido, sexual function, and mood; reduces fat body mass; increases lean body mass; and improves bone mineral density. Testosterone treatment is contraindicated in subjects with prostate cancer or benign prostate hyperplasia and risks of treatment are perceived to be high by many physicians. These risks, however, are often exaggerated and should not outweigh the benefits of testosterone treatment.