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Testosterone Treatment in Adult Men with Age-Related Low TestosteroneTestosterone Treatment in Adult Men With Age-Related Low Testosterone | Annals of Internal Medicine | American College of Physicians '); } '); })(); Sign in below to access your subscription for full content INDIVIDUAL SIGN IN | You will be directed to acponline.org to register and create your Annals account INSTITUTIONAL SIGN IN | | Subscribe to Annals of Internal Medicine . You will be directed to acponline.org to complete (...) your purchase. Search Clinical Guidelines | 21 January 2020 Testosterone Treatment in Adult Men With Age-Related Low Testosterone: A Clinical Guideline From the American College of Physicians Free Amir Qaseem, MD, PhD, MHA; Carrie A. Horwitch, MD, MPH; Sandeep Vijan, MD, MS; Itziar Etxeandia-Ikobaltzeta, PhD; Devan Kansagara, MD, MCR; for the Clinical Guidelines Committee of the American College of Physicians Amir Qaseem, MD, PhD, MHA American College of Physicians, Philadelphia, Pennsylvania (A.Q
What is the role of free testosterone testing in the workup of suspected male hypogonadism? Chiefs’ Inquiry Corner – 9/16/19 – Clinical Correlations Search Chiefs’ Inquiry Corner – 9/16/19 September 16, 2019 2 min read Free testosterone is generally not needed in the workup of male hypogonadism, as total testosterone is generally a good proxy, and a more reliable test (with some caveats- see below!). One exception to this rule is in patients with a suspected sex hormone binding globulin (...) deficiency (as in the case of obesity, type 2 diabetes or steroid exposure), in whom total testosterone can be low while the free fraction remains normal. If measuring free testosterone, be aware that the most commonly used assay, the direct immunoassay (or analog assay), is notoriously unreliable. Instead, order free testosterone by equilibrium dialysis, a test which is only available in a few specialized endocrinology labs. References: In men with signs and symptoms of possible hypogonadism
Testosterone replacement in menopause BRITISH MENOPAUSE SOCIETY T ool for clinicians Information for GPs and other health professionals 1 of 4 1 How much and where does it come from? Testosterone is an important female hormone. Healthy young women produce approximately 100 – 400 mcg per day. This represents three to four times the amount of estrogen produced by the ovaries. Approximately half of endogenous testosterone and precursors are derived from the ovaries e.g. androstenedione and half (...) from the adrenal glands e.g. dehydroepiandrosterone. Some of the effects are direct and some due to peripheral conversion to estrogen by aromatase. Testosterone levels naturally decline throughout a woman’s lifespan. Loss of testosterone is particularly profound after iatrogenic i.e. surgical and medical menopause and premature ovarian insufficiency when testosterone production decreases by more than 50%. 2 What is its role in women? Testosterone contributes to libido, sexual arousal and orgasm
Safety and efficacy of testosterone for women: a systematic review and meta-analysis of randomised controlled trial data The benefits and risks of testosterone treatment for women with diminished sexual wellbeing remain controversial. We did a systematic review and meta-analysis to assess potential benefits and risks of testosterone for women.We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and Web of Science for blinded, randomised controlled trials (...) of testosterone treatment of at least 12 weeks' duration completed between Jan 1, 1990, and Dec 10, 2018. We also searched drug registration applications to the European Medicine Agency and the US Food and Drug Administration to identify any unpublished data. Primary outcomes were the effects of testosterone on sexual function, cardiometabolic variables, cognitive measures, and musculoskeletal health. This study is registered with the International Prospective Register of Systematic Reviews (PROSPERO), number
Testosterone Replacement Guidelines Page | 1 BSPED Guideline: Testosterone Therapy in Infancy and Adolescence Initial authors: R El-Khairi, N Shaw, EC Crowne (November 2016) Revision: A Chinoy, EC Crowne, M Skae (January 2018) Scope This guideline is intended for general paediatricians and paediatric endocrinologists who are regularly managing boys with absent/delayed puberty requiring exogenous testosterone therapy. This includes boys with hypogonadotrophic hypogonadism (HH) of various (...) aetiology, androgen deficiency secondary to testicular failure (hypergonadotrophic hypogonadism) of various aetiology, and constitutional delay of growth and puberty (CDGP). The aim of testosterone replacement therapy is to mimic the normal pattern of puberty and mimic requirements at different stages of pubertal development 1 . This guideline aims to provide the clinician with testosterone dosing regimens for pubertal induction, progression and post-pubertal maintenance, as well as for penile growth
Testosterone (Testavan) - testosterone replacement therapy for adult male hypogonadism Published 08 April 2019 1 www.scottishmedicines.org.uk Product update SMC2152 testosterone 20mg/g transdermal gel (Testavan®) Ferring Pharmaceuticals Ltd 8 March 2019 The Scottish Medicines Consortium (SMC) has completed its assessment of the above product and advises NHS Boards and Area Drug and Therapeutic Committees (ADTCs) on its use in NHSScotland. The advice is summarised as follows: ADVICE: following (...) an abbreviated submission testosterone gel (Testavan ® ) is accepted for restricted use within NHSScotland. Indication under review: testosterone replacement therapy for adult male hypogonadism, when testosterone deficiency has been confirmed by clinical features and biochemical tests. SMC restriction: patients requiring a transdermal delivery system. Testosterone (Testavan ® ) is bioequivalent to another testosterone transdermal preparation and costs less. Advice context: No part of this advice may be used
Association of genetically predicted testosterone with thromboembolism, heart failure, and myocardial infarction: mendelian randomisation study in UK Biobank. To determine whether endogenous testosterone has a causal role in thromboembolism, heart failure, and myocardial infarction.Two sample mendelian randomisation study using genetic variants as instrumental variables, randomly allocated at conception, to infer causality as additional randomised evidence.Reduction by Dutasteride of Prostate (...) participants, 13 691 had thromboembolism (6208 men, 7483 women), 1688 had heart failure (1186, 502), and 12 882 had myocardial infarction (10 136, 2746). In men, endogenous testosterone genetically predicted by variants in the JMJD1C gene region was positively associated with thromboembolism (odds ratio per unit increase in log transformed testosterone (nmol/L) 2.09, 95% confidence interval 1.27 to 3.46) and heart failure (7.81, 2.56 to 23.8), but not myocardial infarction (1.17, 0.78 to 1.75
Testosterone Testing - Protocol Testosterone Testing - Protocol - Province of British Columbia theme_3_collection theme_3_frontend theme_3_collection theme_3_frontend Birth, Adoption, Death, Marriage & Divorce theme_1_collection theme_1_frontend theme_1_collection theme_1_frontend British Columbians & Our Governments theme_data_collection data_frontend theme_data_collection data_frontend Data theme_5_collection theme_5_frontend theme_5_collection theme_5_frontend Driving & Transportation (...) & Culture theme_8_collection theme_8_frontend theme_8_collection theme_8_frontend Taxes & Tax Credits theme_14_collection theme_14_frontend theme_14_collection theme_14_frontend Tourism & Immigration Search default_collection default_frontend Section Navigation Testosterone Testing - Protocol Effective Date: September 19, 2018 Recommendations and Topics Scope This protocol reviews the appropriate use of serum testosterone testing in men and women aged ≥ 19 years. This document is intended to direct
Testosterone reduces the threat premium in competitive resource division. Like other animals, humans are sensitive to facial cues of threat. Recent evidence suggests that we use this information to dynamically calibrate competitive decision-making over resources, ceding more to high-threat individuals (who appear more willing/able to retaliate) and keeping more from low-threat individuals. Little is known, however, about the biological factors that support such threat assessment and decision (...) -making systems. In a pre-registered, double-blind, placebo-controlled, cross-over testosterone administration study ( n = 118 men), we show for the first time that testosterone reduces the effects of threat on decision-making: participants ceded more resources to high-threat (versus low-threat) individuals (replicating the 'threat premium'), but this effect was blunted by testosterone, which selectively reduced the amount of resources ceded to those highest in threat. Thus, our findings suggest
Exogenous Testosterone Does Not Influence 11-Oxygenated C19 Steroid Concentrations in Healthy Postmenopausal Women. 11β-Hydroxyandrostenedione (11OHA4), 11β-hydroxytestosterone (11OHT), and their respective peripheral derivatives, 11-ketoandrostenedione (11KA4) and 11-ketotesosterone (11KT), have been implicated in androgen-related physiopathology. Little is known of these steroids in postmenopausal women or whether exogenous testosterone therapy influences their levels.The impact of exogenous (...) testosterone on serum levels of 11-oxygenated steroids was determined in healthy postmenopausal women.Levels of 19-carbon (C19) steroids were measured by liquid chromatography-tandem mass spectrometry in serum obtained at baseline and at 12 and 26 weeks from 73 healthy postmenopausal women, aged 55 to 65 years, who participated in a randomized, double-blind, placebo-controlled clinical trial assessing the effects of transdermal testosterone on cognitive performance.Of the 11-oxygenated androgens, 11OHA4
Pharmacokinetics and Acceptability of Subcutaneous Injection of Testosterone Undecanoate. Can injectable testosterone undecanoate (TU) be administered effectively and acceptably by the subcutaneous (SC) route?To investigate the acceptability and pharmacokinetics (PK) of SC injection of TU.Randomized sequence, crossover clinical study of SC vs IM TU injections.Ambulatory clinic of an academic andrology center.Twenty men (11 hypogonadal, 9 transgender men) who were long-term users of TU (...) . injections. Intervention: Injection of 1000 mg TU (in 4 mL castor oil vehicle) by SC or IM route. Main Outcome Measures: Patient-reported pain, acceptability, and preference scales. PK by measurement of serum testosterone, dihydrotestosterone (DHT), and estradiol (E2) concentrations with application of population PK methods and dried blood spot (DBS) sampling.Pain was greater after SC compared with IM injection 24 hours (but not immediately) after injection but both routes were equally acceptable
Feedback on LH in Testosterone-Clamped Men Depends on the Mode of Testosterone Administration and Body Composition. Quantitative studies of the short-term feedback of testosterone (T) on luteinizing hormone (LH) secretion in healthy men are relatively rare. Such studies require the shutting down of endogenous T secretion and the imposition of experimentally controlled IV T addback.To evaluate whether pulsatile and continuous T delivery confers equivalent negative feedback on LH secretion.This
Testosterone therapy and venous thromboembolism: A systematic review and meta-analysis Testosterone prescribing for men has dramatically increased, and there have been concerns about inappropriate use and adverse events. While regulatory bodies have warned about increased risk of venous thromboembolism (VTE), published clinical data supporting an increased risk for VTE are limited.To conduct a systematic review of studies examining the association between testosterone therapy in men (...) and VTE.Comprehensive searches of multiple databases were performed from inception through October 3rd, 2018. Randomized control trials (RCTs) and observational studies examining the association between exogenous testosterone (any route) and VTE. Study selection and data extraction were performed by two independent investigators. Random-effect model meta-analyses were used to estimate pooled odds ratios (OR) and 95% confidence intervals (CIs). Heterogeneity among studies was evaluated using the I2 statistic. Risk
Increase in Osteocalcin Following Testosterone Therapy in Men With Type 2 Diabetes and Subnormal Free Testosterone. One-third of men with type 2 diabetes have subnormal free testosterone concentrations. We evaluated the following: (i) whether bone mineral density (BMD) and bone strength are affected by gonadal status in type 2 diabetes and (ii) the effect of testosterone replacement on markers of osteoblast and osteoclast activity.This is a secondary analysis of a previously completed (...) , randomized, placebo-controlled trial. Ninety-four men with type 2 diabetes were recruited; 44 had subnormal free testosterone concentrations. Men with subnormal free testosterone concentrations were randomized to receive intramuscular injections of testosterone or placebo every 2 weeks for 22 weeks. Dual energy X-ray absorptiometry scans were performed at baseline and at 23 weeks.Men with subnormal free testosterone had similar BMD compared with men with normal free testosterone. However, bone strength
Association of Testosterone Treatment With Alleviation of Depressive Symptoms in Men: A Systematic Review and Meta-analysis Countering depressive disorders is a public health priority. Currently, antidepressants are the first-line treatment, although they show modest effects. In men, testosterone treatment is a controversial alternative or adjunct treatment option.To examine the association of testosterone treatment with alleviation of depressive symptoms in men and to clarify moderating (...) effects of testosterone status, depression status, age, treatment duration, and dosage.English-language studies published in peer-reviewed journals identified from PubMed/Medline, Embase, Scopus, PsychINFO, and the Cochrane Controlled Trials Register from database inception to March 5, 2018, using the search terms testosterone, mood, administration, dosage, adverse effects, deficiency, standards, therapeutic use, therapy, treatment, and supplementation.Randomized placebo-controlled clinical trials
Multi-year patterns in testosterone, cortisol and corticosterone in baleen from adult males of three whale species Male baleen whales have long been suspected to have annual cycles in testosterone, but due to difficulty in collecting endocrine samples, little direct evidence exists to confirm this hypothesis. Potential influences of stress or adrenal stress hormones (cortisol, corticosterone) on male reproduction have also been difficult to study. Baleen has recently been shown to accumulate (...) steroid hormones during growth, such that a single baleen plate contains a continuous, multi-year retrospective record of the whale's endocrine history. As a preliminary investigation into potential testosterone cyclicity in male whales and influences of stress, we determined patterns in immunoreactive testosterone, two glucocorticoids (cortisol and corticosterone), and stable-isotope (SI) ratios, across the full length of baleen plates from a bowhead whale (Balaena mysticetus), a North Atlantic right
Testosterone Top results for testosterone - Trip Database or use your Google+ account Find evidence fast ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4 (...) ) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Latest & greatest articles for testosterone The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you
Estradiol Does Not Influence Lipid Measures and Inflammatory Markers in Testosterone-Clamped Healthy Men Experimentally controlled studies of estrogenic regulation of lipid measures and inflammatory cytokines in men are rare.To delineate the effect of estradiol (E2) on lipids and inflammatory markers.This was a placebo-controlled, single-masked, prospectively randomized study comprising experimentally degarelix-downregulated healthy men [n = 74; age 65 years (range, 57 to 77)] assigned to four (...) treatment groups: (1) IM saline and oral placebo; (2) IM testosterone and oral placebo; (3) IM testosterone and oral anastrozole (aromatase inhibitor); and (4) IM testosterone, oral anastrozole, and transdermal E2 for 22 (±1) days.Mean mass spectrometry-quantified serum E2 concentrations ranged from 1.2 to 82 pg/mL in the four treatment groups. E2 extremes did not alter total cholesterol, triglyceride, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein cholesterol (HDL-C) , non-HDL-C
Evaluation and Management of Testosterone Deficiency 1 Executive Summary Testosterone testing and prescriptions have nearly tripled in recent years; however, it is clear from clinical practice that there are many men using testosterone without a clear indication. 1-3 Some studies estimate that up to 25% of men who receive testosterone therapy do not have their testosterone tested prior to initiation of treatment. 2, 3 Of men who are treated with testosterone, nearly half do not have (...) their testosterone levels checked after therapy commences. 2, 3 While up to a third of men who are placed on testosterone therapy do not meet the criteria to be diagnosed as testosterone deficient, 2, 3 there are a large percentage of men in need of testosterone therapy who fail to receive it due to clinician concerns, mainly surrounding prostate cancer development and cardiovascular events, although current evidence fails to definitively support these concerns. Given the clinical and commercial testosterone