hypogonadism%20in%20males%20-%20late-onset
HYPOGONADISM IN MALES - LATE-ONSET
Late onset hypogonadism is defined as clinical and biochemical syndrome characterized by older age, set of typical symptoms, and deficiency in serum testosterone levels.
The quality of life may be decreased and multiple organ systems may be adversely affected.
Prior to the start of testosterone substitution, there should be confirmation of low serum testosterone and a confirmation of need based on clinical findings.
Only if the potential benefit exceeds the risk, then replacement testosterone should be started.

Follow Up

  • The patient should be monitored carefully (by monthly check-up every 3 months) for the development of adverse effects

At 1 Month & 3 monthly therafter

  • Follow up w/ patients to assess that the desired testosterone level is achieved
    • Optimal serum testosterone level for efficacy is unknown
    • It is generally recommended that mid to lower young adult levels may be appropriate as the therapeutic goal 
  • Evaluate the patient for complications/adverse effects & determine if symptoms are improving

During 1st Year of Therapy

  • Perform prostate exam, PSA, hematocrit every 3 months
    • Hematocrit >54% requires dose reduction or temporary medication discontinuation
    • If the PSA increases >0.75 ng/mL over 2 consecutive controls or a PSA level abnormal for age (>4 ng/mL), further exam & eventual biopsy may be needed
  • Plasma lipid determinations at the 3rd & 6th month of therapy
  • Liver function test, urinalysis & measurement of bone markers may be done at the 6th month

At 1 Year

  • Repeat all previous tests done on the 6th month
  • Blood glucose control should be evaluated by fasting blood glucose (FBG), post-prandial glucose (PPG) or HbA1c
  • After the 1st year, follow-up may be done every 6 months for 2 years & annually thereafter
Editor's Recommendations
Most Read Articles
Stephen Padilla, 5 days ago
Increased coffee consumption appears to lower the risk of colon adenoma, results of a meta-analysis have shown. However, this association should be carefully considered due to latent confusion and different exposure classification.
29 Nov 2019
Metformin Extended Release 500 mg,750 mg, and 1000 mg
01 Dec 2019
Pneumonia is a common infection– affecting around 3,200 people inSingapore in 2016 – making it the thirdmost common cause of hospitalisation inthe country. Its common complications,especially with delayed or inappropriatetreatment, include bacteraemia andseptic shock, lung abscesses, pleuraleffusions, empyema, pleurisy, respiratoryfailure and renal failure.
23 Dec 2019
At a Menarini-sponsored symposium held during the Asian Pacific Society Congress, renowned cardiologist Prof John Camm provided the latest evidence for chronic stable angina with or without concomitant diseases, with a special focus on the antianginal agent ranolazine and combination therapies. The event was chaired and moderated by Dr Dante Morales from the University of the Philippines College of Medicine.