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Archive for the ‘Hypogonadism’ Category

Late-onset hypogonadism – Wikipedia

Late-onset hypogonadism is a rare condition in older men, characterized by measurably low testosterone levels and clinical symptoms mostly of a sexual nature, including decreased desire for sex, fewer spontaneous erections, and erectile dysfunction.[1] It is the result of a gradual drop in testosterone; a steady decline in testosterone levels of about 1% per year can happen and is well documented in both men and women.[2][3]

Late-onset hypogonadism is an endocrine condition as well as a result of aging.[1]

The terms “male menopause” and “andropause” are used in the popular media and are misleading, as they imply a sudden change in hormone levels similar to what women experience in menopause.[4]

As of 2016, the International Society for the Study of the Aging Male defines late-onset hypogonadism as a series of symptoms in older adults related to testosterone deficiency that combines features of both primary and secondary hypogonadism; the European Male Aging Study (a prospective study of ~3000 men)[5] defined the condition by the presence of at least three sexual symptoms (e.g. reduced libido, reduced spontaneous erections, and erectile dysfunction) and total testosterone concentrations less than 11 nmol/l (3.2ng/ml) and free testosterone concentrations less than 220 pmol/l (64 pg/ml).[1]

Some men present with the symptoms, but with normal testosterone levels, and some men with low testosterone levels have no symptoms; the reasons for this are not known.[1][6]

Some men in their late 40s and early 50s develop depression, loss of libido, erectile dysfunction, and other physical and emotional symptoms such as irritability, loss of muscle mass and reduced ability to exercise, weight gain, lack of energy, difficulty sleeping, or poor concentration; many of these symptoms may arise from a midlife crisis or as the results of a long-term unhealthy lifestyle (smoking, excess drinking, overeating, lack of exercise) and may be best addressed by lifestyle changes, therapy, or antidepressants.[4]

If a person has symptoms of late-onset hypogonadism, testosterone is measured by taking blood in the morning on at least two days; while immunoassays are commonly used, mass spectrometry is more accurate and is becoming more widely available.[6] The meaning of the measurement is different depending on many factors that affect how testosterone is made and how it is carried in the blood. Increased concentrations of proteins that bind testosterone in blood occur if the person is older, has hyperthyroidism or liver disease, or is taking anticonvulsant drugs (which are increasingly used for depression and various neuropathies), and decreased concentrations of proteins that bind testosterone occur if the person is obese, has diabetes, has hypothyroidism, has liver disease, or is taking glucocorticoids or androgens, or progestins.[6] If levels are low, conditions that cause primary and secondary hypogonadism need to be ruled out.[6][7][8]

Due to difficulty and expense of testing, and the ambiguity of the results, screening is not recommended.[1][6] While some clinical instruments (standard surveys) had been developed as of 2016, their specificity was too low to be useful clinically.[1]

Testosterone levels can and are well-documented to decline with aging at about 1% per year in both men and women after a certain age; the causes are not well understood.[1][2][3][9][10]

The significance of a decrease in testosterone levels is debated and its treatment with replacement is controversial. The Food and Drug Administration (FDA) stated in 2015 that neither the benefits nor the safety of testosterone have been established in older men with low testosterone levels.[11] Testosterone replacement therapy should only be started if low levels have been confirmed;[7] in the US, this confirmation is not done about 25% of the time, as of 2015.[8] Testosterone levels should also be monitored during therapy.[7]

Adverse effects of testosterone supplementation may include increased cardiovascular (CV) events (including strokes and heart attacks) and deaths, especially in men over 65 and men with pre-existing heart conditions.[1] The potential for CV risks from testosterone therapy led the FDA to issue a requirement in 2015 that testosterone pharmaceutical labels include warning information about the possibility of an increased risk of heart attacks and stroke.[1][11] However, the data are mixed, so the European Medicines Agency, the American Association of Clinical Endocrinologists, and the American College of Endocrinology have stated that no consistent evidence shows that testosterone therapy either increases or decreases cardiovascular risk.[1]

Other significant adverse effects of testosterone supplementation include acceleration of pre-existing prostate cancer growth; increased hematocrit, which can require venipuncture to treat; and, exacerbation of sleep apnea.[1]

Adverse effects may also include minor side effects such as acne and oily skin, as well as significant hair loss and/or thinning of the hair, which may be prevented with 5-alpha reductase inhibitors ordinarily used for the treatment of benign prostatic hyperplasia, such as finasteride or dutasteride.[12]

Exogenous testosterone may also cause suppression of spermatogenesis, leading to, in some cases, infertility.[1]

As of 2015, the evidence is inconclusive as to whether testosterone replacement therapy can help with erectile dysfunction in men with late-onset hypogonadism.[8] It appears that testosterone replacement therapy may benefit men with symptoms of frailty who have late-onset hypogonadism.[8]

The epidemiology is not clear; 20% of men in their 60s and 30% of men in their 70s have low testosterone;[2][8] around 5% of men between 70 and 79 have both low testosterone and the symptoms, so are diagnosed with late-onset hypogonadism.[2] The National Health Service describes it as rare.[4]

The impact of low levels of testosterone has been previously reported. In 1944, Heller and Myers identified symptoms of what they labeled the “male climacteric” including loss of libido and potency, nervousness, depression, impaired memory, the inability to concentrate, fatigue, insomnia, hot flushes, and sweating. Heller and Myers found that their subjects had lower than normal levels of testosterone, and that symptoms decreased dramatically when patients were given replacement doses of testosterone.[13][14]

Popular interest in the concept of “andropause” was fueled by the 1998 book Male Menopause, written by Jed Diamond, a lay person.[15] According to Diamond’s view, andropause is a change of life in middle-aged men, which has hormonal, physical, psychological, interpersonal, social, sexual, and spiritual aspects. Diamond claims that this change occurs in all men, may occur as early as age 45 to 50 and more dramatically after the age of 70 in some men, and that women’s and men’s experiences are somewhat similar phenomena.[16][17] The language of “andropause” and its supposed parallels with menopause have been rejected by the medical community.[4][18]

Thomas Perls and David J. Handelsman, in a 2015 editorial in the Journal of the American Geriatrics Society, say that between the ill-defined nature of the diagnosis and the pressure and advertising from drug companies selling testosterone and human growth hormone, as well as dietary supplement companies selling all kinds of “boosters” for aging men, the condition is overdiagnosed and overtreated.[19] Perls and Handelsman note that in the US, “sales of testosterone increased from $324 million in 2002 to $2 billion in 2012, and the number of testosterone doses prescribed climbed from 100 million in 2007 to half a billion in 2012, not including the additional contributions from compounding pharmacies, Internet, and direct-to-patient clinic sales.”[19]

As of 2016, research was necessary to find better ways to measure testosterone and to be better able to understand the measurements in any given person, and to understand why some people with low testosterone do not present with symptoms and some with seemingly adequate levels do present with symptoms.[1] Research was also necessary to better understand the cardiovascular risks of testosterone replacement therapy in older men.[1]

A relationship between late-onset hypogonadism and risk of Alzheimer’s disease and some small clinical studies have been conducted to prevent Alzheimer’s disease in men with late-onset hypogonadism; as of 2009, results were inconclusive.[20]

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Late-onset hypogonadism – Wikipedia

Hypogonadism Treatment & Management: Approach Considerations …

In prepubertal patients with hypogonadism, treatment is directed at initiating pubertal development at the appropriate age. Age of therapy initiation takes into account the patient’s psychosocial needs, current growth, and growth potential. Treatment entails hormonal replacement therapy with sex steroids, ie,estrogen for females and testosterone for males.

Introduction of sex steroids in such cases startswith the use ofsmall, escalating doses over a period of a couple of years. In females, introduction of puberty can begin with administration of small doses of estrogen given either orally or transdermally. One traditional regimen uses conjugated estrogen startingat doses as low as 0.15 mg daily and titrating upwards in 6-12 month intervals to typically 0.625 mg daily, at which point menses can be induced with the introduction of a progestin. Alternatively, transdermal 17-estradiol (0.08 to 0.12 mcg estradiol/kg) can be used.

In boys, introduction of puberty is achieved with the use of testosterone, administered intramuscularly or transdermally (in the form of a patch or gel). A typical regimen involves testosterone enanthate injections 50 mg monthly, titrating up to 200-250 mg every 2 weeks, which is a typical adult replacement dose. Adult testosterone dose can be adjusted to maintain serum testosterone concentrations in the normal adult range.

Therapy with sexsteroid replacement ensures development of secondary sexual characteristics and maintenance of normal sexual function. In patients with hypergonadotropic hypogonadism, fertility is not possible. However, patients with hypogonadotropic hypogonadism have fertilitypotential,although therapy with sex steroids does not confer fertility or stimulate testicular growth in men.An alternative for men with hypogonadotropic hypogonadism has been treatment with pulsatile LHRH or hCG, either of which can stimulate testicular growth and spermatogenesis.

Because such treatment is more complex than testosterone replacement, and because treatment with testosterone does not interfere with later therapy to induce fertility, most male patients with hypogonadotropic hypogonadism prefer to initiate and maintain virilization with testosterone.At a time when fertility is desired, it may be induced with either pulsatile LHRH or (more commonly) with a schedule of injections of hCG and FSH. Similarly, fertility can be achieved in females with pulsatile LHRH or exogenous gonadotropin. Such therapy results in ovulation in 95% of women.

A phase III, multicenter, open-label, single-arm trial by Nieschlag et al indicated that corifollitropin-alfa therapy combined with hCG treatment can significantly increase testicular volume and induce spermatogenesis in adult males with hypogonadotropic hypogonadism whose azoospermia could not be cured by hCG treatment alone. Patients in the study who remained azoospermic, though with normalized testosterone levels, after 16 weeks of hCG treatment underwent 52 weeks of twice-weekly hCG therapy along with every-other-week corifollitropin-alfa treatment (150 g). Mean testicular volume in these patients rose from 8.6 mL to 17.8 mL, while spermatogenesis was induced in more than 75% of subjects. [10]

The use of oral testosterone preparations, such as 17-alkylated androgens (eg, methyltestosterone), is discouraged because of liver toxicity. However, oral testosterone undecanoate is available in some countriesand is now approved in the United States. Intramuscular testosterone is available as testosterone enanthate or cypionate. Transdermal testosterone can be administered either in the form of a patch or gel. A nasal testosterone replacement therapy has been approved by the US Food and Drug Administration (FDA) for adult males with conditions such as primary hypogonadism (congenital or acquired) and hypogonadotropic hypogonadism (congenital or acquired) resulting from a deficiency or absence of endogenous testosterone. [11] The recommended dosage is 33 mg/day in three divided doses. The drug has not been approved for males younger than 18 years.

For older men with testosterone deficiency, a review by the Pharmacovigilance Risk Assessment Committee (PRAC) of the European Medicines Agency (EMA) found that the evidence concerning the risk of serious cardiovascular side effects from the use of testosterone in men with hypogonadism was inconsistent. [12, 13] The PRAC determined that the benefits of testosterone outweigh its risks but stressed that testosterone-containing medicines should be used only when lack of testosterone has been confirmed by signs and symptoms, as well as by laboratory tests. However,a literature review by Albert and Morley indicated that testosterone supplementation in males aged 65 years or older may increase the risk of cardiovascular events, particularly during the first year of treatment, althoughintramuscular testosterone seemed to carry less risk than other forms. [14]

On the other hand,a study by Traish et al suggested that long-term testosterone therapy in men with hypogonadism significantly reduces cardiovascular diseaserelated mortality. Patients in the studys testosterone-treated group (n=360) underwent therapy for up to 10 years, with median follow-up being 7 years. The investigators found no cardiovascular eventrelated deaths in the treated patients, compared with 19 such deaths in the group that received no testosterone therapy (n=296). According to the study, mortality in the testosterone-treated patients was reduced by an estimated 66-92%. [15]

A literature review by Corona et al indicated that testosterone replacement therapy is safe for age- or comorbidity-related (functional) male hypogonadism, not just for the organic variety. The investigators reported that the safety of testosterone replacement therapy in functional cases, with regard to cardiovascular and venous thromboembolism risk, as well as prostate concerns, is high enough to allow for the treatment. [16]

The latest Endocrine Society clinical practice guidelines suggest testosterone therapy for men receiving high doses of glucocorticoids who also have low testosterone levels, to promote bone health. The guidelines also suggest such therapy in human immunodeficiency virus (HIV)infected men with low testosterone levels, to maintain lean bone mass and muscle strength.

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Hypogonadism Treatment & Management: Approach Considerations …

Hypogonadism: Practice Essentials, Background, Pathophysiology

Morbidity for men and women with hypogonadism includes infertility and an increased risk of osteoporosis; there is no increase in mortality.

Hypogonadotropic hypogonadism (see the image below) is one of several types of hypogonadism.

History

Considerations in the evaluation of males with hypogonadism include the following:

For postpubertal males, the rate of beard growth, libido and sexual function, muscle strength, and energy levels

Possible causes of acquired testicular failure (eg, mumps orchitis, trauma, radiation exposure of the head or testes, and chemotherapy)

Drugs that may interrupt testicular function -Including agents that interfere with testosterone synthesis, such as spironolactone andcyproterone.Agents such as cortisol,marijuana, heroin, and methadone may interfere with gonadotropin secretion.

Considerations in the evaluation of females with hypogonadism include the following:

Signs associated with Turner syndrome (eg, lymphedema, cardiac or renal congenital anomalies, and short growth pattern)

Age of menarche

Physical examination

Considerations in the physical examination of males with hypogonadism include the following:

Evaluation of the testes: This is the most important feature of the physical examination; determine whether both testes are palpable, their position in the scrotum, and their consistency; testes size can be quantitated by comparison with testicular models (orchidometer), or their length and width may be measured

Examination of the genitalia for hypospadias

Examination of the scrotum to see if it is completely fused

Evaluation of the extent of virilization

Staging of puberty: Use the Tanner criteria for genitalia, pubic hair, and axillary hair

Examination for signs of Klinefelter syndrome (eg, tall stature, especially if the legs are disproportionately long, gynecomastia, small or soft testes, and a eunuchoid body habitus)

Considerations in the physical examination of females with hypogonadism include the following:

Examination of the genitalia is important

Determination of the extent of androgenization: May be adrenal or ovarian in origin and is demonstrated in pubic and axillary hair

Determination of the extent of estrogenization: As evidenced by breast development and maturation of the vaginal mucosa

Examination for signs of Turner syndrome (eg, short stature, webbing of the neck [such as pterygium colli], a highly arched palate, short fourth metacarpals, widely spaced nipples, or multiple pigmented nevi)

See Clinical Presentation for more detail.

The following studies may be indicated in males with hypogonadism:

Follicle-stimulating hormone (FSH) levels

Luteinizing hormone (LH) levels

Prolactin levels

Testosterone levels

Thyroid function

Seminal fluid examination

Karyotyping

Testicular biopsy

For males after puberty, the Guidelines of the Endocrine Society [2] require that the diagnosis of hypogonadism be based on symptoms and signs of hypogonadism plus the presence of a low testosterone level measured on at least 2 occasions.

The following studies may be indicated in females with hypogonadism:

Additional tests in the evaluation of patients with hypogonadism include the following:

Adrenocorticotropic hormone (ACTH) stimulation testing: In patients in whom a form of congenital adrenal hyperplasia is suspected, adrenal steroid synthesis is best evaluated by performing a cosyntropin (ACTH 1-24) stimulation test

Luteinizing-hormone releasing hormone (LHRH) stimulation testing: To distinguish between true hypogonadotropic hypogonadism and constitutional delay in growth and maturation

Testicular tissue testing: If the testes are not palpable and if it is not certain whether any testicular tissue is present, administering human chorionic gonadotropin (hCG) and measuring testosterone response may be helpful

See Workup for more detail.

Hormonal replacement

The simplest and most successful treatment for males and females with either hypergonadotropic or hypogonadotropic hypogonadism is replacement of sex steroids, but the therapy does not confer fertility or, in men, stimulate testicular growth.

When fertility is desired, an alternative therapy for men with hypogonadotropic hypogonadism is administration of pulsatile LHRH or injections of hCG and FSH. (In patients with hypergonadotropic hypogonadism, fertility is not possible.)

In a 6-year European study of men being treated for hypogonadism, long-term transdermal testosterone treatment did not increase prostate-specific antigen (PSA) levels or influence prostate cancer risk. [3, 4]

Investigators used data from a 5-year, open-label extension of a 1-year trial of a transdermal testosterone patch (Testopatch) in men with hypogonadism. Study subjects wore two 60 cm2 patches, each of which delivered 2.4 mg of testosterone per day. More than 90% of patients had PSA concentrations below 2 ng/mL during the 6-year study, and no prostate cancer was found in patients over the course of the trial.

See Treatment and Medication for more detail.

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Hypogonadism: Practice Essentials, Background, Pathophysiology

Hypogonadism – UCSF Medical Center

Hypogonadism is a condition that causes decreased function of the gonads, which are the testis in males and the ovaries in females, and the production of hormones that play a role in sexual development during puberty. You may be born with the condition or it can develop later in life from injury or infection. Some types of hypogonadism can be treated with hormone replacement therapy.

There are two forms of the condition primary hypogonadism resulting from problems of the testis or ovary and central hypogonadism caused by problems with the pituitary or hypothalamic glands. Central hypogonadism leads to decreased levels of luteinizing hormone (LH) and follicle stimulating hormones (FSH), released by the pituitary gland.

The condition may have genetic, menopausal autoimmune and viral causes or may develop after cancer treatments such as radiation and chemotherapy.

Fasting, weight loss, eating disorders such as anorexia nervosa, and bulimia, and stressful conditions can cause the condition.

In children before puberty, hypogonadism causes no symptoms. In adolescents, it can delay or prevent exual development.

Adult women with the condition may stop menstruating or develop infertility, loss of libido, vaginal dryness and hot flashes. Prolonged periods of hypogonadism can cause osteoporosis.

Men with the condition may experience loss of libido, erectile dysfunction and infertility.

To diagnose hypogonadism, tests may be performed to check hormone levels estogren in females and testosterone in males. In addition, levels of luteinizing hormone (LH) and follicle stimulating hormones (FSH) will be tested. LH and FSH are pituitary hormones that are stimulated by the gonads.

Other tests may measure thyroid hormones, sperm count and prolactin, a hormone released by the pituitary gland that stimulates breast development and milk production Tests also may be performed to test for anemia and possible genetic causes of symptoms.

For women, your doctor may request a sonogram of your ovaries.

If pituitary disease is suspected, a magnetic resonance imaging (MRI) scan or computed tomography (CT) scan may be performed to examine the the pituitary gland.

Hormone replacement therapy has proven to be effective treatment for hypogonadism in men and pre-menopausal women.

Estrogen may be administered in the form of a patch or pill. Testosterone can be given by a patch, a product soaked in by the gums, a gel or by injection.

For women who have not had their uterus removed, a combination of estrogen and progesterone is often recommended to decrease the chance of developing endometrial cancer. Low-dose testosterone may be added for women with hypogonadism who have a low sex drive.

Other hormones may be prescribed to restore fertility in men and women.

Reviewed by health care specialists at UCSF Medical Center.

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Hypogonadism – UCSF Medical Center

Diminished Androgen and Estrogen Receptors and Aromatase …

Aims: One third of males with type 2 diabetes have hypogonadism, characterized by low total and free testosterone concentrations. We hypothesized that this condition is associated with a compensatory increase in the expression of androgen receptors (AR) and that testosterone replacement reverses these changes. We also measured estrogen receptor and aromatase expression.

Materials and Methods: This is a randomized double-blind placebo controlled trial. 32 hypogonadal and 32 eugonadal men with type 2 diabetes were recruited. Hypogonadal men were randomized to receive intramuscular testosterone or saline every 2 weeks for 22 weeks. We measured AR, ER and aromatase expression in peripheral blood mononuclear cells (MNC) and adipose tissue in hypogonadal and eugonadal males with type 2 diabetes at baseline and after 22 weeks of treatment in those with hypogonadism.

Results: The mRNA expression of AR, ER and aromatase in adipose tissue from hypogonadal men was significantly lower as compared to eugonadal men and it increased significantly to levels comparable to those in eugonadal patients with type 2 diabetes following testosterone treatment. AR mRNA expression was also significantly lower in MNC from hypogonadal patients compared to eugonadal T2DM patients. Testosterone administration in hypogonadal patients also restored AR mRNA and nuclear extract protein levels from MNC to that in eugonadal patients.

Conclusions: We conclude that, contrary to our hypothesis, the expression of AR, ER and aromatase is significantly diminished in hypogonadal men as compared to eugonadal men with type 2 diabetes. Following testosterone replacement, there is a reversal of these deficits.

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Diminished Androgen and Estrogen Receptors and Aromatase …

Healthier Andropause Build to Balance

To the men out there, this post is for you! Im sure youre well aware that testosterone is critical for your health and vitality. But are you aware of its decline during the aging process, and that you can start doing something about it today with healthy diet and lifestyle practices?

Andropause, sometimes referred to as Male Menopause or Hypogonadism, is the decline of testosterone production in aging men (starting around 50s). Testosterone is a male sex hormone that is important for sexual and reproductive development. The hormone influences sex drive, sperm production, fat distribution, red cell production, maintenance of muscle strength and mass, and the prevention of osteoporosis in men. When its production starts to decline, primarily due to aging, men can experience unfavorable symptoms (many similar to menopause):

Aging is an inevitable part of life, and a top contributing factor for andropause. SHBG (sex hormone binding globulin) increases with age, which binds with testosterone rendering it unavailable. A healthy diet and lifestyle can help slow the aging process and the onset of andropause. Here is what to focus on:

Bottom line keep that male vitality going strong today and every day by adopting a healthy diet and lifestyle.

References:

Bauman, E. NC202.2 Mens & Womens Health Lecture 2 (PowerPoint Handout). Retrieved from Bauman College: https://baumancollege.instructure.com

Rettner, R. (June 2017). What is Testosterone? Live Science. Retrieved from https://www.livescience.com/38963-testosterone.html

The Truth About Alcohol, Fat Loss, and Testosterone. (Oct. 2016). Prostate.net.Retrieved fromhttps://prostate.net/articles/join-30-day-alcohol-fast-t-levels-liver-will-thank

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Healthier Andropause Build to Balance

Attention, Men: Doing This Every Day Could Lower Your …

Got a headache? Take an ibuprofen. Sore muscles? Pop a painkiller. But if you take a daily dose of ibuprofen, we have some bad news: All of those pills can add up. They might increase your risk ofheart attacksandcausemuscle weakness, for starters. Now, new research shows that ibuprofen can damage fertility, too.

According to a new study published in Proceedings of the National Academy of Sciences, men who take this popular pain reliever over a long period of time might be more likely to develop a condition called compensated hypogonadism, which could reduce their fertility. Find out the other daily habits that may be harming your fertility.

For the study, 31 men between the ages of 18 and 35 took 600 milligrams (three tablets) a day of ibuprofen for six weeks. Other volunteers received a placebo drug. Then, a team of researchers from Denmark and France monitored the participants for two weeks.

By the end of the study, all of the volunteers showed higher levels of luteinizing hormones, which prevented certain cells in their testicles from producing testosterone. The researchers also found that participants’ pituitary glands were producing more of another hormone that encouraged their bodies to produce more testosterone.

While the combination of these two responses kept the participants’ overall testosterone levels constant, the changes still overworked their bodies, causing compensated hypogonadism. This condition can cause a temporary reduction in the production of sperm cells in men, reducing their fertility.

But hold upyou might not want to toss those painkillers just yet. It’s likely that the average ibuprofen user won’t experience any negative side effects to their fertility; on the other hand, regularly using the drug for long periods of time could be cause for concern, researchers say. Still, it cant hurt to cut back on the pills in the meantime, regardless of your normal doseat least until further studies are done.

Concerned about your baby-making ability? Heres what men can do to boost their fertility.

[Source: MedicalXpress]

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Attention, Men: Doing This Every Day Could Lower Your …

Lilly pulls Axiron from Korean market | Righting Injustice

Eli Lilly & Co. has taken its topical testosterone replacement therapy Axiron off the market in Korea after gaining the blessing of the countrys Ministry of Food and Drug Safety. The company said that it made the decision to withdraw the treatment from the market in Korea due to several factors including low male menopause awareness and the existence of substitutable medicines.

Axiron was developed by Australian pharmaceutical company Acrux and marketed by U.S.-based Lilly. It was approved by the U.S. Food and Drug Administration (FDA) in 2010 for the treatment of hypogonadism, a condition in which men do not produce enough of the male hormone due to injury, disease or defect. Axiron was approved by Koreas Ministry of Food and Drug Safety in November 2013, and hit the market there in 2014.

Lilly pulled Axiron from the U.S. as well as other countries, including Australia, last year, citing multiple commercial manufacturers supplying the U.S. market.

Not only was Eli Lilly & Co. facing growing competition from generic Axiron in the U.S., the company is also facing a slew of lawsuits as part of a multidistrict litigation naming several makers of testosterone replacement therapies for not warning the drug could incease the risk of heart attacks, strokes, blood clots and death. Two cases against AbbVie Inc., over its AndroGel testosterone treatment have been tried resulting in verdicts totaling nearly $300 million.

Lilly was to face its first two bellwether trials in the multidictrict litigation this month and in March, but announced it had reached a global settlement in all the cases. The judge overseeing the cases canceled the trial dates involving Axiron.

Sources:Korea Bio MedRighting Injustice

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Lilly pulls Axiron from Korean market | Righting Injustice

Hypogonadism | Cleveland Clinic

What is hypogonadism?

Hypogonadism is a condition in which the testicles are not working the way they should.

In an adult, the testicles have two main functions: to make testosterone (the male hormone) and sperm. These activities are controlled by a part of the brain called the pituitary. The pituitary sends signals (called gonadotropins) to the testicles that, under normal conditions, cause the testicles to produce sperm and testosterone.

The pituitary signals can change based on the feedback signals that the brain receives from the testicle. Hypogonadism can therefore be divided into two main categories:

These categories are important because they may influence the way that hypogonadism is treated, and play a role in the results.

Testicular failure occurs when the brain is signaling the testicle to make testosterone and sperm, but the testicles are not responding correctly. As a result, the brain increases the amount of the gonadotropins signals, which causes a higher-than-normal level of these signals in the blood. For this reason, this condition is also referred to as hypergonadotropic hypogonadism. This is the most common category of hypogonadism.

Secondary hypogonadism (also called hypogonadotropic hypogonadism) occurs when the brain fails to signal the testicles properly. In men who have secondary hypogonadism, the testosterone levels may be very low, and sperm are usually missing from the semen. Some boys are born with this condition. In most cases, it is discovered when a boy fails to go through puberty.

Causes of primary hypogonadism include:

Causes of secondary hypogonadism include:

Low testosterone: Hypogonadism may be diagnosed when a man has symptoms of low testosterone, including low energy, fatigue, and a lower sexual drive.

Patients with secondary hypogonadism are usually diagnosed during their teen years because they have not started puberty. These patients may not develop the body type, muscle build, or hair pattern seen in adult males. Some men will also have a poor sense of smell.

Infertility: Hypogonadism may be diagnosed when a man has a problem with fertility (cannot father a child) and is found to have no sperm or only a very low number of sperm in the semen.

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Hypogonadism | Cleveland Clinic

Primary Hypogonadism VS Secondary Hypogonadism …

Most men who require hormone replacement therapy with testosterone have some form of testicular injury or primary hypogonadism. In other words, the problem is all in their balls. Those of us who have secondary hypogonadism often have perfectly functioning testes, but the problem lies elsewhere in whats known as the Hypothalamus Pituitary Testicular Axis (HPTA), which is responsible for keeping our male hormones in proper balance.

The problem with secondary hypogonadism, is that the treatment actually CAUSES primary hypogonadism by introducing exogenous (external) testosterone into the system. To understand that, first lets go over some basics

Hypothalamus:Among other things, this part of your brain sends GnRH (gonadotropin releasing hormone) down to instruct the pituitary gland to create more LH and FSH.

Pituitary Gland:Among other things (like growth hormone), this gland at the base of your brain secretes LH (luteinizing hormone) and FSH (follicle stimulating hormone), which travel down to the testes / gonads to instruct them to create more testosterone.

Testes / Gonads:Endocrinologists might get upset that I use these terms interchangeably. Oh well, screw em. You get the point. Your balls get the message from your pituitary gland to make more testosterone.

The Axis:The important thing to remember about the hypothalamus pituitary testicular axis (HPTA), also sometimes called thehypothalamic-pituitary-gonadal axis (HPG), is that it does not run only in one direction. The body tries to reach homeostasis a healthy balance of these hormones and the entire system can fall out of whack once you start introducing any of these hormones from outside sources. Which brings me to

The Problem With Taking Testosterone to Treat Secondary Hypogonadism:First of all, lets be clear I take testosterone to treat my secondary hypogonadism. Thats because there is currently no choice. Why cure something when you can have a customer for life? Why treat my bodys inability to create enough GnRH when that would require research money and you already have a product that fixes my symptoms ?

Digression aside, the problem with introducing an external source of testosterone is that eventually your gonads see that they are no longer needed. They pack their bags, or rather pack INTO their bags, and practically disappear over time. Now guess what? Not only do I have secondary hypogonadism, which might have been made even worse, but I now have a classic case of primary hypogonadism to deal with if I the medical community should ever find a treatment for secondary hypogonadism.

Heres an idea Why dont pharmaceutical companies make GnRH and market that to the endocrinologists so they can treat the source of my problem? Am I being naive here? Is there more to it than my not-medically-trained mind understands?

All gripes aside, I do feel great. Sure Ill be tied to this drug like a prisoner for the rest of my life, but I feel ten years younger. Im happy, confident, strong, lean, sharp, motivated, and a lot more fun in the bedroom. And Ive yet to see any CONVINCING studies about the long-term health dangers of testosterone replacement in hypogonadal men. Heart disease? Prostate cancer? Show me the studies? These are often-quoted side-effects, but all I hear are doctors deducing them because, for instance, taking away a mans testosterone seems to help with pre-existing conditions of prostate cancer. But that is not a cause-and-effect relationship. Just because removing testosterone helps treat or minimizes the recurrence of prostate cancer, doesnt mean it causes prostate cancer. Does it? OK, ok, thats anothe post entirely

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Primary Hypogonadism VS Secondary Hypogonadism …

Hypogonadism | Children’s Hospital of Philadelphia

Hypogonadism is a condition in which the bodys sex glands make little or no sex hormone. The sex glands are the testes in males and the ovaries in females. During puberty, sex hormones help control the development of breasts, testicles and pubic hair. They are also key for menstruation and sperm production.

Depending on when it begins, hypogonadism may affect the development of sex organs, interfere with puberty or cause infertility and sexual dysfunction.

Children with hypogonadism do not progress through puberty. Girls dont menstruate or develop breasts. Their overall growth is slowed.

Boys with hypogonadism have slowed muscle and genital development. Their arms and legs are long in relation to their torso. Body hair is sparse and their voice does not deepen.

Hypogonadism that appears after puberty will stop a womans menstrual cycle and may cause hot flashes. Men with hypogonadism have a decreased sex drive, muscle loss and breast development.

If the cause is a brain tumor, symptoms may include headaches or vision loss and a milky discharge from the breasts.

The two types of hypogonadism are called primary and central. In primary hypogonadism, the testes or ovaries dont function properly. In central hypogonadism, the hypothalamus and pituitary gland dont function properly. These areas of the brain signal the testes or ovaries to produce sex hormones. This form of hypogonadism can cause infertility.

The most common cause of primary hypogonadism is Klinefelter syndrome in boys and Turner syndrome in girls. One in 2,500 to 10,000 babies are born with Turner syndrome and 1 in 500 to 1,000 are born with Klinefelter syndrome.

Other causes of primary hypogonadism are:

Causes of central hypogonadism include:

Central hypogonadism affects boys and girls equally.

Diagnosis begins with a physical examination to check your childs progress through puberty. Your childs doctor will order blood tests to check the levels of testosterone or estrogen and the puberty hormones, such as LH (lutenizing hormone) and FSH (follicle-stimulating hormone).

Your childs doctor may also order imaging tests, such as an MRI or CT scan to check for tumors in the pituitary gland, and an ultrasound to look for ovarian cysts or other disorders of the ovaries.

Many forms of hypogonadism are treatable with hormone replacement therapy. Girls and women will take estrogen and progesterone are used for girls and women. Boys and men will take testosterone.

If hypogonadism is caused by a tumor on the pituitary gland, treatment may include radiation, medication or surgery to shrink or remove the tumor.

With ongoing hormone replacement therapy, men and women with hypogonadism are able to live a normal life.

The rest is here:
Hypogonadism | Children’s Hospital of Philadelphia

Male hypogonadism – Diagnosis and treatment – Mayo Clinic

Diagnosis

Your doctor will conduct a physical exam during which he or she will note whether your sexual development, such as your pubic hair, muscle mass and size of your testes, is consistent with your age. Your doctor may test your blood level of testosterone if you have any of the signs or symptoms of hypogonadism.

Early detection in boys can help prevent problems from delayed puberty. Early diagnosis and treatment in men offer better protection against osteoporosis and other related conditions.

Doctors base a diagnosis of hypogonadism on symptoms and results of blood tests that measure testosterone levels. Because testosterone levels vary and are generally highest in the morning, blood testing is usually done early in the day, before 10 a.m.

If tests confirm you have low testosterone, further testing can determine if a testicular disorder or a pituitary abnormality is the cause. Based on specific signs and symptoms, additional studies can pinpoint the cause. These studies may include:

Testosterone testing also plays an important role in managing hypogonadism. This helps your doctor determine the right dosage of medication, both initially and over time.

Treatment for male hypogonadism depends on the cause and whether you’re concerned about fertility.

Hormone replacement. For hypogonadism caused by testicular failure, doctors use male hormone replacement therapy (testosterone replacement therapy, or TRT). TRT can restore muscle strength and prevent bone loss. In addition, men receiving TRT may experience an increase in energy, sex drive, erectile function and sense of well-being.

If a pituitary problem is the cause, pituitary hormones may stimulate sperm production and restore fertility. Testosterone replacement therapy can be used if fertility isn’t an issue. A pituitary tumor may require surgical removal, medication, radiation or the replacement of other hormones.

In boys, testosterone replacement therapy (TRT) can stimulate puberty and the development of secondary sex characteristics, such as increased muscle mass, beard and pubic hair growth, and growth of the penis. Pituitary hormones may be used to stimulate testicle growth. An initial low dose of testosterone with gradual increases may help to avoid adverse effects and more closely mimic the slow increase in testosterone that occurs during puberty.

Several testosterone delivery methods exist. Choosing a specific therapy depends on your preference of a particular delivery system, the side effects and the cost. Methods include:

Injection. Testosterone injections (testosterone cypionate, testosterone enanthate) are safe and effective. Injections are given in a muscle. Your symptoms might fluctuate between doses depending on the frequency of injections.

You or a family member can learn to give TRT injections at home. If you’re uncomfortable giving yourself injections, a nurse or doctor can give the injections.

Testosterone undecanoate (Aveed), an injection recently approved by the Food and Drug Administration, is injected less frequently but must be administered by a health care provider and can have serious side effects.

Gel. There are several gel preparations available with different ways of applying them. Depending on the brand, you either rub testosterone gel into your skin on your upper arm or shoulder (AndroGel, Testim, Vogelxo), apply with an applicator under each armpit (Axiron) or pump on your front and inner thigh (Fortesta).

As the gel dries, your body absorbs testosterone through your skin. Gel application of testosterone replacement therapy appears to cause fewer skin reactions than patches do. Don’t shower or bathe for several hours after a gel application, to be sure it gets absorbed.

A potential side effect of the gel is the possibility of transferring the medication to another person. Avoid skin-to-skin contact until the gel is completely dry or cover the area after an application.

Oral testosterone isn’t recommended for long-term hormone replacement because it might cause liver problems.

Testosterone therapy carries various risks, including contributing to sleep apnea, stimulating noncancerous growth of the prostate, enlarging breasts, limiting sperm production, stimulating growth of existing prostate cancer and blood clots forming in the veins. Recent research also suggests testosterone therapy might increase your risk of a heart attack.

Reduce stress. Talk with your doctor about how you can reduce the anxiety and stress that often accompany these conditions. Many men benefit from psychological or family counseling.

Support groups can help people with hypogonadism and related conditions cope with similar situations and challenges. Helping your family understand the diagnosis of hypogonadism also is important.

Although you’re likely to start by seeing your family doctor or general practitioner, you may need to consult a doctor who specializes in the hormone-producing glands (endocrinologist). If your primary care doctor suspects you have male hypogonadism, he or she may refer you to an endocrinologist. Or, you can ask for a referral.

Here’s some information to help you get ready for your appointment and know what to expect from your doctor.

Preparing a list of questions for your doctor will help you make the most of your time together. For male hypogonadism, some basic questions to ask your doctor include:

Don’t hesitate to ask other questions you have.

Your doctor is likely to ask you a number of questions, such as:

Sept. 29, 2016

See more here:
Male hypogonadism – Diagnosis and treatment – Mayo Clinic

Hypogonadism Causes & Information | Cleveland Clinic

What is hypogonadism?

Hypogonadism is a condition in which the testicles are not working the way they should.

In an adult, the testicles have two main functions: to make testosterone (the male hormone) and sperm. These activities are controlled by a part of the brain called the pituitary. The pituitary sends signals (called gonadotropins) to the testicles that, under normal conditions, cause the testicles to produce sperm and testosterone.

The pituitary signals can change based on the feedback signals that the brain receives from the testicle. Hypogonadism can therefore be divided into two main categories:

These categories are important because they may influence the way that hypogonadism is treated, and play a role in the results.

Testicular failure occurs when the brain is signaling the testicle to make testosterone and sperm, but the testicles are not responding correctly. As a result, the brain increases the amount of the gonadotropins signals, which causes a higher-than-normal level of these signals in the blood. For this reason, this condition is also referred to as hypergonadotropic hypogonadism. This is the most common category of hypogonadism.

Secondary hypogonadism (also called hypogonadotropic hypogonadism) occurs when the brain fails to signal the testicles properly. In men who have secondary hypogonadism, the testosterone levels may be very low, and sperm are usually missing from the semen. Some boys are born with this condition. In most cases, it is discovered when a boy fails to go through puberty.

Causes of primary hypogonadism include:

Causes of secondary hypogonadism include:

Low testosterone: Hypogonadism may be diagnosed when a man has symptoms of low testosterone, including low energy, fatigue, and a lower sexual drive.

Patients with secondary hypogonadism are usually diagnosed during their teen years because they have not started puberty. These patients may not develop the body type, muscle build, or hair pattern seen in adult males. Some men will also have a poor sense of smell.

Infertility: Hypogonadism may be diagnosed when a man has a problem with fertility (cannot father a child) and is found to have no sperm or only a very low number of sperm in the semen.

More here:
Hypogonadism Causes & Information | Cleveland Clinic

Low Testosterone | Hormone Health Network

What is the role of testosterone in mens health?

Testosterone is the most important sex hormone that men have. It is responsible for the typical male characteristics, such as facial, pubic, and body hair as well as muscle. This hormone also helps maintain sex drive, sperm production, and bone health. The brain and pituitary gland (a small gland at the base of the brain) control the production of testosterone by the testes.

In the short term, low testosterone (also called hypogonadism) can cause:

Over time, low testosterone may cause a man to lose body hair, muscle bulk, and strength and to gain body fat. Chronic (long-term) low testosterone may also cause weak bones (osteoporosis), mood changes, less energy, and smaller testes. Signs and symptoms (what you see and feel) vary from person to person.

Low testosterone can result from:

Low testosterone is common in older men. In many cases, the cause is not known.

During a physical exam, your doctor will examine your body hair, size of your breasts and penis, and the size and consistency of the testes and scrotum. Your doctor may check for loss of side vision, which could indicate a pituitary tumor, a rare cause of low testosterone.

Your doctor will also use blood tests to see if your total testosterone level is low. The normal range is generally 300 to 1,000 ng/dL, but this depends on the lab that conducts the test. To get a diagnosis of low testosterone, you may need more than one early morning (710 AM) blood test and, sometimes, tests of pituitary gland hormones.

If you have symptoms of low testosterone, your doctor may suggest that you talk with an endocrinologist. This expert in hormones can help find the cause. Be open with your doctor about your medical history, all prescription and nonprescription drugs you are now taking, sexual problems, and any major changes in your life.

Testosterone replacement therapy can improve sexual interest, erections, mood and energy, body hair growth, bone density, and muscle mass. There are several ways to replace testosterone:

The best method will depend on your preference and tolerance, and the cost.

There are risks with long-term use of testosterone. The most serious possible risk is prostate cancer. African American men, men over 40 years of age who have close relatives with prostate cancer, and all men over 50 years of age need monitoring for prostate cancer during testosterone treatment. Men with known or suspected prostate cancer, or with breast cancer, should not receive testosterone treatment.

Other possible risks of testosterone treatment include:

Read more from the original source:
Low Testosterone | Hormone Health Network

Induction of fertility in men with secondary hypogonadism

INTRODUCTION

Sperm production cannot be stimulated in men who are infertile as a result of primary hypogonadism due to damage to the seminiferous tubules. On the other hand, sperm production can usually be stimulated to a level sufficient to restore fertility in men who are infertile as a result of secondary hypogonadism, ie, due to damage to the pituitary or hypothalamus. Men who have pituitary disease can be treated with gonadotropins, while those with hypothalamic disease can be treated with gonadotropins or gonadotropin-releasing hormone (GnRH). (See “Causes of secondary hypogonadism in males”.)

PRETREATMENT EVALUATION

Which patients are likely to respond?The diagnosis of secondary hypogonadism must be firmly established before therapy is begun, since only patients whose infertility is due to this disorder will respond. We recommend treatment with gonadotropins for most men who have secondary hypogonadism due to either hypothalamic or pituitary disease who wish to become fertile (see “Clinical features and diagnosis of male hypogonadism”). Gonadotropin treatment will not increase the sperm count in men who have idiopathic oligospermia, in which a subnormal sperm count is associated with a normal serum testosterone concentration [1].

Several factors enhance the likelihood that the sperm count will be increased, and increased sooner after gonadotropin administration:

Development of hypogonadism after puberty rather than before. In one study, as an example, all six men whose hypogonadism occurred postpubertally experienced an increase in total sperm count from less than one million to above 40 million per ejaculate when treated with human chorionic gonadotropin (hCG) (see ‘Initial treatment: hCG’ below). In comparison, only one of eight men whose hypogonadism occurred prepubertally (but without cryptorchidism) had a similar response [2].

Partial hypogonadism, rather than complete, as judged by testes that are not as small [3-6], and serum concentrations of follicle-stimulating hormone (FSH), inhibin B, and testosterone that are not as low [7].

Literature review current through:Oct 2017.|This topic last updated:Dec 16, 2015.

View post:
Induction of fertility in men with secondary hypogonadism

Hypogonadism, Male | ARUPConsult Lab Test Selection

Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS, Montori VM, Task Force, Endocrine Society. Testosterone therapy in men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2010; 95(6): 2536-59. PubMed

Choosing Wisely. An initiative of the ABIM Foundation. [Accessed: Sep 2017]

Dean JD, McMahon CG, Guay AT, Morgentaler A, Althof SE, Becher EF, Bivalacqua TJ, Burnett AL, Buvat J, Meliegy AE, Hellstrom WJ, Jannini EA, Maggi M, McCullough A, Torres LO, Zitzmann M. The International Society for Sexual Medicine’s Process of Care for the Assessment and Management of Testosterone Deficiency in Adult Men. J Sex Med. 2015; 12(8): 1660-86. PubMed

Dohle G, Arver S, Bettocchi C, et al. Guidelines on male hypogonadism. European Association of Urology. Arnhem (the Netherlands) [Accessed: Jun 2017]

Kushnir MM, Blamires T, Rockwood AL, Roberts WL, Yue B, Erdogan E, Bunker AM, Meikle W. Liquid chromatography-tandem mass spectrometry assay for androstenedione, dehydroepiandrosterone, and testosterone with pediatric and adult reference intervals. Clin Chem. 2010; 56(7): 1138-47. PubMed

Morales A, Bebb RA, Manjoo P, Assimakopoulos P, Axler J, Collier C, Elliott S, Goldenberg L, Gottesman I, Grober ED, Guyatt GH, Holmes DT, Lee JC, Canadian Mens Health Foundation Multidisciplinary Guidelines Task Force on Testosterone Deficiency. Diagnosis and management of testosterone deficiency syndrome in men: clinical practice guideline. CMAJ. 2015; 187(18): 1369-77. PubMed

Paduch DA, Brannigan RE, Fuchs EF, Kim ED, Marmar JL, Sandlow JI. The laboratory diagnosis of testosterone deficiency. Urology. 2014; 83(5): 980-8. PubMed

Seftel AD, Kathrins M, Niederberger C. Critical Update of the 2010 Endocrine Society Clinical Practice Guidelines for Male Hypogonadism: A Systematic Analysis. Mayo Clin Proc. 2015; 90(8): 1104-15. PubMed

The rest is here:
Hypogonadism, Male | ARUPConsult Lab Test Selection

Hypogonadism Testosterone Therapy Treatment | Ageonics Medical

Hypogonadism is the underproduction of sex hormones by the gonads, or sex organs. Male hypogonadism refers to the underproduction of testosterone, which can severely limit a growing boys sexual development and frustrate an adult males quality of life.

The easiest way to understand the effects of hypogonadism is to understand the effects of proper testosterone levels in a mans development. The male sex hormone contributes to everything from the deepening of the voice, the growth of body hair, and muscle building to sex drive and general self confidence. A lack of testosterone has the opposite effect, and can contribute to a higher-pitched voice, loss of body hair, muscle loss, lowered sex drive, and decreased confidence.

Hypogonadism can occur as early as fetal development, which may lead to androgyny, but male hypogonadism in particular can also occur as a result of testicular injury. Hypogonadism sustained before puberty is particularly problematic, as it will greatly affect puberty. Low testosterone during puberty can lead to:

Hypogonadism that occurs after puberty is less obvious, but can also lead to major problems, such as:

While these are some of the physical symptoms of hypogonadism, it is worth noting that hypogonadism, no matter when it occurs, can also lead to persistent psychological and emotional duress. Common stressors that accompany male hypogonadism may include:

Areas Low Testosterone Can Affect

Many adult males who have gone through puberty normally but experience hypogonadism in later life may not recognize its symptoms. If you suspect that you may be suffering from hypogonadism, testosterone replacement therapy is a potential treatment option. The pervasive symptoms of hypogonadism are caused in large part by low testosterone, and testosterone replacement therapy can greatly improve quality of life and sex drive.

Dr. Olivieri has many decades of experience treating men with low testosterone, and has helped thousands of men experience the benefits of normal testosterone levels, improving their lives, marriages, and mobility. If you know someone who may be suffering from hypogonadism or low testosterone in general, consider calling Aegonics Medical for a consultation.

The rest is here:
Hypogonadism Testosterone Therapy Treatment | Ageonics Medical

Hypogonadism: Types, Causes, & Symptoms – healthline.com

What Is Hypogonadism?

Hypogonadism occurs when your sex glands produce little or no sex hormones. The sex glands, also calledgonads, are primarily the testes in men and the ovaries in women. Sex hormones help control secondary sex characteristics, such as breast development in women, testicular development in men, and pubic hair growth. Sex hormones also play a role in the menstrual cycle and sperm production.

Hypogonadism may also be known asgonad deficiency. It may be calledlow serum testosteroneorandropause when it happens in males.

Most cases of this disorder respond well to appropriate medical treatment.

9 Warning Signs of Low Testosterone

Types

There two types of hypogonadism are primary and central hypogonadism.

Primary hypogonadism means that you dont have enough sex hormones in your body due to a problem in your gonads. Your gonads are still receiving the message to produce hormones from your brain, but they arent able to produce them.

In central hypogonadism, the problem lies in your brain. The hypothalamus and pituitary gland in your brain, which control your gonads, arent working properly.

Causes

The causes of primary hypogonadism include:

Central, or secondary, hypogonadism may be due to:

Symptoms

Symptoms that may affect females include:

Symptoms that may affect males include:

Diagnosis

Your doctor will conduct a physical exam to confirm that your sexual development is at the proper level for your age. They may examine your muscle mass, body hair, and your sexual organs.

If your doctor thinks you might have hypogonadism, the first round of testing will involve checking your sex hormone levels. Youll need a blood test to check your level of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Your pituitary gland makes these reproductive hormones.

Youll have your estrogen level tested if youre female. Youll have your testosterone level tested if youre male. These tests are usually drawn in the morning, which is when your hormone levels are highest. If youre male, your doctor may also order a semen analysis to check your sperm count. Hypogonadism can reduce your sperm count.

Your doctor may order more blood tests to help confirm the diagnosis of hypogonadism and rule out any underlying causes.

Iron levels can affect your sex hormones. For this reason, your doctor may test for anemia, or iron deficiency. Your doctor may also wish to measure your prolactin levels. Prolactin is a hormone that promotes breast development and breast milk production in women, but its present in both genders. Your doctor may also check your thyroid hormone levels because thyroid problems can cause symptoms similar to hypogonadism.

Imaging tests can also be useful in diagnosis. Anultrasoundof the ovaries uses sound waves to create an image of the ovaries and check for any problems, including ovarian cysts and polycystic ovarian syndrome (PCOS).Your doctor may order MRIscans or CTscans to check for tumors in your pituitary gland.

Treatments

Your treatment will involve increasing the amount of female sex hormones in your body if youre a woman.

Your first line of treatment will probably be estrogen therapy if youve had a hysterectomy. Either a patch or pill can administer the supplemental estrogen hormone.

Because increased estrogen levels can increase your risk of endometrial cancer, youll be given a combination of estrogen and progesterone if women who havent had a hysterectomy. Progesterone can lower your risk of endometrial cancer if youre taking estrogen.

Other treatments can target specific symptoms. If youre a woman and you have a decreased sex drive, you may receive low doses of testosterone. If you have menstrual irregularities or trouble conceiving, you may receive injections of the hormone human choriogonadotropin (hCG) or pills containing FSH to trigger ovulation.

Testosterone is a male sex hormone. Testosterone replacement therapy (TRT) is a widely used treatment for hypogonadism in males. You can get testosterone replacement therapy by:

Injections of a gonadotropin-releasing hormone may trigger puberty or increase your sperm production.

Treatment for males and females is similar if the hypogonadism is due to a tumor on the pituitary gland. Treatment may include radiation, medication, or surgery to shrink or remove the tumor.

Outlook

According to the Urology Care Foundation, hypogonadism is a chronic condition that requires lifelong treatment. Your sex hormone level will probably decrease if you stop treatment.

Seeking support through therapy or support groups can help you before, during, and after treatment.

Can Testosterone Supplements Improve Your Sex Drive?

See the rest here:
Hypogonadism: Types, Causes, & Symptoms – healthline.com

Male Hypogonadism Drug Market Analysis, Share and Size, Trends, Industry Growth And Segment Forecasts To 2021 – satPRnews (press release)

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Continue reading here:
Male Hypogonadism Drug Market Analysis, Share and Size, Trends, Industry Growth And Segment Forecasts To 2021 – satPRnews (press release)

Asia-Pacific Male Hypogonadism Market by Region, Production, Consumption, Revenue, Market Share and Growth … – satPRnews (press release)

MarketResearchNest.com adds Asia-Pacific Male Hypogonadism Market Report 2017new report to its research database. The report spread across 113 pages with multiple tables and figures in it.

This report studies the Asia-Pacific Male Hypogonadism market status and outlook of global and major regions, from angles of manufacturers, regions, product types and end industries; this report analyzes the top manufacturers in global and major regions, and splits the Asia-Pacific Male Hypogonadism market by product type and applications/end industries.

The global Asia-Pacific Male Hypogonadism market is valued at XX million USD in 2016 and is expected to reach XX million USD by the end of 2022, growing at a CAGR of XX% between 2016 and 2022.

Browse full table of contents and data tables at

https://www.marketresearchnest.com/asia-pacific-male-hypogonadism-market-report-2017.html

Major players in the market are identified through secondary research and their market revenues determined through primary and secondary research. The major players in Asia-Pacific Male Hypogonadism market include

Astrazeneca Plc., Merck & Co. Inc., Laboratories Genevrier, Allergan Plc., Endo International Plc., Ferring, AbbVie Inc., Eli Lilly and Company Ltd., Finox Biotech, Teva Pharmaceutical Industries Ltd., Bayer AG, IBSA Institut Biochimque.

Geographically, this report is segmented into several key Regions, with production, consumption, revenue, market share and growth rate of Asia-Pacific Male Hypogonadism in these regions, from 2012 to 2022 (forecast), covering

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Asia-Pacific Male Hypogonadism Market (K Units) and Revenue (Million USD) Market Split by Regions

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On the basis of product, the Asia-Pacific Male Hypogonadism market is primarily split intoTestosterone Replacement Therapy, Gonadotropin-Releasing Hormones Therapy.

Asia-Pacific Male Hypogonadism Market (K Units) and Revenue (Million USD) Market Split by Product Type

On the basis on the end users/applications, this report focuses on the status and outlook for major applications/end users, consumption (sales), market share and growth rate of Asia-Pacific Male Hypogonadism for each application, including:

Kallmann Syndrome, Klinefelters Syndrome, Pituitary Disorders, Others.

Asia-Pacific Male Hypogonadism Market (K Units) and Revenue (Million USD) Market Split by end users

This research study involved the extensive usage of both primary and secondary data sources. The research process involved the study of various factors affecting the industry, including the government policy, market environment, competitive landscape, historical data, present trends in the market, technological innovation, upcoming technologies and the technical progress in related industry, and market risks, opportunities, market barriers and challenges. The following illustrative figure shows the market research methodology applied in this report.

All possible factors that influence the markets included in this research study have been accounted for, viewed in extensive detail, verified through primary research, and analyzed to get the final quantitative and qualitative data. The market size for top-level markets and sub-segments is normalized, and the effect of inflation, economic downturns, and regulatory & policy changes or other factors are not accounted for in the market forecast.

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See the article here:
Asia-Pacific Male Hypogonadism Market by Region, Production, Consumption, Revenue, Market Share and Growth … – satPRnews (press release)

Male hypogonadism – Treatment – Mayo Clinic

Treatment for adults

Treatment for male hypogonadism depends on the cause and whether you’re concerned about fertility.

Hormone replacement. For hypogonadism caused by testicular failure, doctors use male hormone replacement therapy (testosterone replacement therapy, or TRT). TRT can restore muscle strength and prevent bone loss. In addition, men receiving TRT may experience an increase in energy, sex drive, erectile function and sense of well-being.

If a pituitary problem is the cause, pituitary hormones may stimulate sperm production and restore fertility. Testosterone replacement therapy can be used if fertility isn’t an issue. A pituitary tumor may require surgical removal, medication, radiation or the replacement of other hormones.

In boys, testosterone replacement therapy (TRT) can stimulate puberty and the development of secondary sex characteristics, such as increased muscle mass, beard and pubic hair growth, and growth of the penis. Pituitary hormones may be used to stimulate testicle growth. An initial low dose of testosterone with gradual increases may help to avoid adverse effects and more closely mimic the slow increase in testosterone that occurs during puberty.

Several testosterone delivery methods exist. Choosing a specific therapy depends on your preference of a particular delivery system, the side effects and the cost. Methods include:

Injection. Testosterone injections (testosterone cypionate, testosterone enanthate) are safe and effective. Injections are given in a muscle. Your symptoms might fluctuate between doses depending on the frequency of injections.

You or a family member can learn to give TRT injections at home. If you’re uncomfortable giving yourself injections, a nurse or doctor can give the injections.

Testosterone undecanoate (Aveed), an injection recently approved by the Food and Drug Administration, is injected less frequently but must be administered by a health care provider and can have serious side effects.

Gel. There are several gel preparations available with different ways of applying them. Depending on the brand, you either rub testosterone gel into your skin on your upper arm or shoulder (AndroGel, Testim, Vogelxo), apply with an applicator under each armpit (Axiron) or pump on your front and inner thigh (Fortesta).

As the gel dries, your body absorbs testosterone through your skin. Gel application of testosterone replacement therapy appears to cause fewer skin reactions than patches do. Don’t shower or bathe for several hours after a gel application, to be sure it gets absorbed.

A potential side effect of the gel is the possibility of transferring the medication to another person. Avoid skin-to-skin contact until the gel is completely dry or cover the area after an application.

Oral testosterone isn’t recommended for long-term hormone replacement because it might cause liver problems.

Testosterone therapy carries various risks, including contributing to sleep apnea, stimulating noncancerous growth of the prostate, enlarging breasts, limiting sperm production, stimulating growth of existing prostate cancer and blood clots forming in the veins. Recent research also suggests testosterone therapy might increase your risk of a heart attack.

Sept. 29, 2016

Read this article:
Male hypogonadism – Treatment – Mayo Clinic

Wives of 3 of 4 patients treated for hypogonadism conceive – Times of India

Nagpur: For the first time in the city, four patients have undergone treatment for infertility for male hypogonadism. They were put through a therapy conceptualized by endocrinologist Dr Pramod Gandhi following which three of their wives conceived.

On Sunday, Gandhi delivered a talk on ‘Male hypogonadism’ during a medical conference on ‘core endocrinology’ which was organized by the Nagpur Diabetes and Endocrine Centre in collaboration with Diabetic Association of India (DAI) and Association of Medical Faculties (AMF) at a city hotel.

Male hypogonadism, a problem not often discussed at such forums, is a condition in which the body doesn’t produce enough testosterone. It can occur at any age fetal development, before puberty or during adulthood. Signs and symptoms depend on when the condition develops.

Infertility, erectile dysfunction, obesity, loss of strength, decreased beard and body hair growth, decreased sex drive and weakening of bone are the common symptoms.

“Until now, the city couldn’t do much if the patient is suffering from infertility because of hypogonadism,” Gandhi told TOI.

Gandhi combined two injections combined human chorionic gonadotrophin (HCG) and human menopausal gonadotrophin (HMG) to treat the four patients. “Until now both of these injections were being used on women for some other purpose,” he said.

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Wives of 3 of 4 patients treated for hypogonadism conceive – Times of India

Pipeline Landscape of Male Hypogonadism Covering Therapeutic Assessment and Drug Portfolio in 2017 – Digital Journal

Report provides a complete understanding of the pipeline activities covering all clinical, pre-clinical and discovery stage products.

This press release was orginally distributed by SBWire

Albany, NY — (SBWIRE) — 08/16/2017 — The topic of Hypogonadism can be an embarrassing subject for an affected male. Nevertheless, it’s important that any man battling the symptoms of Hypogonadism to get over his embarrassment and be taken care of by a medical professional. A new pipeline study, related to the therapeutics activities for male hypogonadism has been recently broadcasted to the wide repository of Market Research Hub (MRH), with the title of “Male Hypogonadism-Pipeline Insight, 2017”. The study highlights the pharmacological action of various therapeutics and their history of research and development activities.

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Male hypogonadism is defined as the failure of the testes to produce androgen, sperm or both. Although the disorder is extremely common, its exact prevalence is uncertain. It is a condition in which the body doesn’t produce enough testosterone, the hormone that plays a key role in masculine growth and development during puberty. It may adversely affect multiple organ functions and quality of life. Signs and symptoms depend on when the condition develops. The research analyses its symptoms, which include fatigue, hot flashes, infertility, decrease in muscle mass and loss of bone mass (osteoporosis). When hormone levels decline, men can easily experience significant psychological and physical changes.

Moreover, this study provides comprehensive information on the pipeline products with comparative analysis of the products at various stages of development. The coverage of pipeline products based on the numerous stages of development ranging from early development to approved or issued stage. In this subsequent section, details of foremost pipeline products which includes, product description, licensing and collaboration details and other developmental activities are also mentioned. This study has been built using proprietary databases along with latest updates and featured news & press releases from various university sites and industry-specific third party sources.

Looking to the therapeutics overview, the research studies that the levels of testosterone in men start to fall after the age of 40. It has been estimated that 8.4% of men aged 5079 years have testosterone deficiency. Some types of male hypogonadism can be treated with testosterone replacement therapy. There is a lot of research in progress to find out more about the effects of testosterone in older men and also whether the use of testosterone replacement therapy would have any benefits.

Browse Full Report with TOC – http://www.marketresearchhub.com/report/male-hypogonadism-pipeline-insight-2017-report.html

For a competitive analysis, the research has listed key companies operating in the market, focusing on their research and development efforts, adoption to changing trends and their efforts to discover new therapeutics for male hypogonadism. Also, the report covers dormant and discontinued pipeline projects related to the Male Hypogonadism. With this information, the new entrants in the market can modify the therapeutic portfolio by identifying inactive projects and understanding the factors that might have halted their progress.

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About Market Research HubMarket Research Hub (MRH) is a next-generation reseller of research reports and analysis. MRH’s expansive collection of market research reports has been carefully curated to help key personnel and decision makers across industry verticals to clearly visualize their operating environment and take strategic steps.

MRH functions as an integrated platform for the following products and services: Objective and sound market forecasts, qualitative and quantitative analysis, incisive insight into defining industry trends, and market share estimates. Our reputation lies in delivering value and world-class capabilities to our clients.

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For more information on this press release visit: http://www.sbwire.com/press-releases/pipeline-landscape-of-male-hypogonadism-covering-therapeutic-assessment-and-drug-portfolio-in-2017-848559.htm

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Pipeline Landscape of Male Hypogonadism Covering Therapeutic Assessment and Drug Portfolio in 2017 – Digital Journal

Long-term testosterone therapy improves urinary, sexual function and quality of life – Medical Xpress

A new study shows a significant improvement in both sexual and urinary function as well as quality of life for hypogonadal men who undergo long-term testosterone replacement therapy.

These findings appear in the Journal of Urology.

Testosterone is a steroid hormone involved in the regulation of sexual function, urinary health and metabolism as well as a number of other critical functions. For most men, testosterone concentration declines slowly with age and may not cause immediate major symptoms. However, some men may experience a host of signs and sumptoms constituting a clinical condition called Testosterone Deficiency (TD), or male hypogonadism, which is attributed to insufficient levels of testosterone. As a result, they experience symptoms as varied as erectile dysfunction, low energy, fatique, depressed mood and an increased risk of diabetes.

Researchers from the Boston University School of Medicine (BUSM) and Public Health (BUSPH) collaborated with a group of urologists in Germany to investigate the effects of long-term testosterone replacement therapy on urinary health and sexual function as well as quality of life in men with diagnosed, symptomatic testosterone deficiency. More than 650 men in their 50s and 60s enrolled in the study, some with unexplained testosterone deficiency and others with known genetic and auto-immune causes for their hypogonadism.

“It is thought that testosterone treatment in men may increase prostate size and worsen lower urinary tract symptoms,” said Abdulmaged Traish, PhD, professor of urology at BUSM.

However, he and Gheorghe Doros, PhD, professor of biostatistics at BUSPH, discovered that despite increased prostate size in the group that received testosterone therapy, there were fewer urinary symptoms such as frequent urination, incomplete bladder emptying, weak urinary stream and waking up at night to urinate.

In addition to these subjective improvements, the researchers conducted objective testing that showed that those men treated with testosterone emptied their bladders more fully. Finally, testosterone treatment also increased the scores patients received on assessments of their erectile/sexual health and general quality of life.

The findings of this study are of great significance to men suffering with symptomatic testosterone deficiency. Traish emphasized the value of this treatment option, stating that, “[Testosterone therapy] is well-tolerated with progressive and sustained improvement in urinary and sexual function and overall improvement in quality of life.”

Explore further: Testosterone undecanoate improves sexual function in men with type 2 diabetes

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Long-term testosterone therapy improves urinary, sexual function and quality of life – Medical Xpress

Male Hypogonadism Sales Market Research Report 2017 to 2022 – The Donohue Report

Global Male Hypogonadism Sales Market Research Report 2017 to 2022 provides a unique tool for evaluating the market, highlighting opportunities, and supporting strategic and tactical decision-making. This report recognizes that in this rapidly-evolving and competitive environment, up-to-date marketing information is essential to monitor performance and make critical decisions for growth and profitability. It provides information on trends and developments, and focuses on markets and materials, capacities and technologies, and on the changing structure of the Male Hypogonadism Sales Market.

Companies Mentioned are Astrazeneca Plc., Merck & Co. Inc., Laboratories Genevrier, Allergan Plc., Endo International Plc., Ferring, AbbVie Inc., Eli Lilly and Company Ltd., Finox Biotech, Teva Pharmaceutical Industries Ltd., Bayer AG, IBSA Institut Biochimque.

The Global Male Hypogonadism Sales market consists of different international, regional, and local vendors. The market competition is foreseen to grow higher with the rise in technological innovation and M&A activities in the future. Moreover, many local and regional vendors are offering specific application products for varied end-users. The new vendor entrants in the market are finding it hard to compete with the international vendors based on quality, reliability, and innovations in technology.

Inquire for sample copy at: https://www.marketinsightsreports.com/reports/08111359/global-male-hypogonadism-sales-market-report-2017/inquiry

Global Male Hypogonadism Sales (K Units) and Revenue (Million USD) Market Split by Product Type

Global Male Hypogonadism Sales (K Units) by Application (2016-2022)

(2016-2022)

This independent 110 page report guarantees you will remain better informed than your competition. With over 165 tables and figures examining the Male Hypogonadism Sales market, the report gives you a visual, one-stop breakdown of the leading products, submarkets and market leaders market revenue forecasts as well as analysis to 2022.

Geographically, this report is segmented into several key Regions, with production, consumption, revenue (million USD), and market share and growth rate of Male Hypogonadism Sales in these regions, from 2012 to 2022 (forecast), covering

The report provides a basic overview of the Male Hypogonadism Sales industry including definitions, classifications, applications and industry chain structure. And development policies and plans are discussed as well as manufacturing processes and cost structures.

Then, the report focuses on Global major leading industry players with information such as company profiles, product picture and specifications, sales, market share and contact information. Whats more, the Male Hypogonadism Sales industry development trends and marketing channels are analyzed.

Browse full report at: https://www.marketinsightsreports.com/reports/08111359/global-male-hypogonadism-sales-market-report-2017

The research includes historic data from 2012 to 2016 and forecasts until 2022 which makes the reports an invaluable resource for industry executives, marketing, sales and product managers, consultants, analysts, and other people looking for key industry data in readily accessible documents with clearly presented tables and graphs. The report will make detailed analysis mainly on above questions and in-depth research on the development environment, market size, development trend, operation situation and future development trend of Male Hypogonadism Sales on the basis of stating current situation of the industry in 2017 so as to make comprehensive organization and judgment on the competition situation and development trend of Male Hypogonadism Sales Market and assist manufacturers and investment organization to better grasp the development course of Male Hypogonadism Sales Market.

The study was conducted using an objective combination of primary and secondary information including inputs from key participants in the industry. The report contains a comprehensive market and vendor landscape in addition to a SWOT analysis of the key vendors.

There are 15 Chapters to deeply display the Global Male Hypogonadism Sales market.

Chapter 1, to describe Male Hypogonadism Sales Introduction, product scope, market overview, market opportunities, market risk, market driving force;

Chapter 2, to analyze the top manufacturers of Male Hypogonadism Sales , with sales, revenue, and price of Male Hypogonadism Sales , in 2016 and 2017;

Chapter 3, to display the competitive situation among the top manufacturers, with sales, revenue and market share in 2016 and 2017;

Chapter 4, to show the Global market by regions, with sales, revenue and market share of Male Hypogonadism Sales , for each region, from 2012 to 2017;

Chapter 5, 6, 7,8 and 9, to analyze the key regions, with sales, revenue and market share by key countries in these regions;

Chapter 10 and 11, to show the market by type and application, with sales market share and growth rate by type, application, from 2012 to 2017;

Chapter 12, Male Hypogonadism Sales market forecast, by regions, type and application, with sales and revenue, from 2017 to 2022;

Chapter 13, 14 and 15, to describe Male Hypogonadism Sales sales channel, distributors, traders, dealers, Research Findings and Conclusion, appendix and data source.

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Male Hypogonadism Sales Market Research Report 2017 to 2022 – The Donohue Report

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