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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
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
Adverse effects of testosterone therapy in adult men: a systematic review and meta-analysis Adverse effects of testosterone therapy in adult men: a systematic review and meta-analysis Adverse effects of testosterone therapy in adult men: a systematic review and meta-analysis Fernandez-Balsells MM, Murad MH, Lane M, Lampropulos JF, Albuquerque F, Mullan RJ, Agrwal N, Elamin MB, Gallegos-Orozco JF, Wang AT, Erwin PJ, Bhasin S, Montori VM CRD summary This review concluded that although haemoglobin (...) and haematocrit increased and high density lipoprotein cholesterol decreased in men who received testosterone therapy, the clinical significance of these findings was unclear and the evidence base was deficient. The review had some limitations, but the authors were appropriately cautious regarding the reliability of the results given the limitations of the original studies. Authors' objectives To determine the adverse events associated with testosterone therapy in adult men. Searching MEDLINE, EMBASE
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
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
Testosterone supplementation therapy for older men: potential benefits and risks Testosterone supplementation therapy for older men: potential benefits and risks Testosterone supplementation therapy for older men: potential benefits and risks Gruenewald D A, Matsumoto A M CRD summary This review assessed the effects of testosterone supplementation for men older than 60 without severe illness. The authors concluded that supplementation may be helpful for men with low testosterone levels (...) with or without hypogonadism. The review found only a few studies and the stated inclusion criteria were not consistently followed; hence, the conclusions should be interpreted with caution. Authors' objectives To assess the effect of testosterone supplementation therapy in older men. Searching MEDLINE was searched from 1966 to October 2001; the search terms were stated and reports published in any language were eligible. The reference lists of reviews and identified studies were checked. Manual searches
What are the risks of major cardiovascular events (MACE) from testosterone replacement therapy (TRT)? Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation web
Cardiovascular and cerebrovascular safety of testosterone replacement therapy among aging men with low testosterone levels: a cohort study. We assessed the risk of ischemic stroke, transient ischemic attack, and myocardial infarction associated with testosterone replacement therapy (TRT) among aging men with low testosterone levels.Using the UK Clinical Practice Research Datalink (CPRD), we formed a cohort of men aged 45years or older with low testosterone levels and no evidence (...) 1.11-1.27) per 100 persons per year). Compared with nonuse, current use of TRT was associated with an increased risk of the composite outcome (HR 1.21; 95% CI 1.00-1.46). This risk was highest in the first six months to two years of continuous TRT use (HR 1.35; 95% CI 1.01-1.79), as well as among men aged 45-59years (HR 1.44; 95% CI 1.07-1.92).TRT may increase the risk of cardiovascular events in aging men with low testosterone levels, particularly in the first 2years of use. In the absence
Testosterone Replacement Therapy and Risk of Favorable and Aggressive Prostate Cancer Purpose The association between exposure to testosterone replacement therapy (TRT) and prostate cancer risk is controversial. The objective was to examine this association through nationwide, population-based registry data. Methods We performed a nested case-control study in the National Prostate Cancer Register of Sweden, which includes all 38,570 prostate cancer cases diagnosed from 2009 to 2012, and 192,838
Testosterone for Depression, PTSD, or Fibromyalgia: Clinical Effectiveness and Guidelines Testosterone for Depression, PTSD, or Fibromyalgia: Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Testosterone for Depression, PTSD, or Fibromyalgia: Clinical Effectiveness and Guidelines Testosterone for Depression, PTSD, or Fibromyalgia: Clinical Effectiveness and Guidelines Published on: February 9, 2017 Project Number: RA0892-000 Product Line: Research Type: Drug Report (...) Type: Reference List Result type: Report Question What is the clinical effectiveness of testosterone for patients with depression? What is the clinical effectiveness of testosterone for patients with post-traumatic stress disorder? What is the clinical effectiveness of testosterone for patients with fibromyalgia? What are the evidence-based guidelines for the use of testosterone for patients with depression, PTSD, or fibromyalgia? Key Message Two systematic reviews, two randomized controlled trials
Systematic review of testosterone replacement in obese men with low testosterone levels Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation web address: Timing
What Is Andropause? Is Testosterone Supplementation the Answer in Older Men? What Is Andropause? Is Testosterone Supplementation the Answer in Older Men? – Clinical Correlations Search What Is Andropause? Is Testosterone Supplementation the Answer in Older Men? September 20, 2012 5 min read By Kylie Birnbaum Faculty Peer Reviewed Women have long bemoaned menopause and its physiological, psychological, and sexual effects. Fortunately, hormone replacement therapy has provided relief (...) for symptomatic women. Less attention is paid to men, who also experience declines in their sex hormones. Decreased testosterone may explain many symptoms experienced by elderly men, such as poor sexual function and libido, decreased bone mineral density, fatigue, and decreased muscle mass and strength. Should physicians treat elderly men with testosterone replacement therapy? Late-onset hypogonadism, or “andropause,” is the gradual decline in testosterone levels in aging men. It differs from menopause
Testosterone and depression: systematic review and meta-analysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Serum testosterone, testosterone replacement therapy and all-cause mortality in men with type 2 diabetes: retrospective consideration of the impact of PDE5 inhibitors and statins. Low testosterone levels occur in over 40% of men with type 2 diabetes mellitus (T2DM) and have been associated with increased mortality. Testosterone replacement together with statins and phosphodiesterase 5 inhibitors (PDE5I) are widely used in men with T2DM.To determine the impact of testosterone and testosterone (...) replacement therapy (TRT) on mortality and assess the independence of this effect by adjusting statistical models for statin and PDE5I use.We studied 857 men with T2DM screened from five primary care practices during April 2007-April 2009. Of the 857 men, 175/637 men with serum total testosterone ≤ 12 nmol/l or free testosterone (FT) ≤ 0.25 nmol/l received TU for a mean of 3.8 ± 1.2 (SD) years. PDE5I and statins were prescribed to 175/857 and 662/857 men respectively. All-cause mortality was the primary
Testosterone Supplementation Testosterone Supplementation Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Testosterone Supplementation (...) Testosterone Supplementation Aka: Testosterone Supplementation , Testosterone Replacement , Androgen Replacement , Androderm , Testoderm , Testim , Fortesta , Androgel II. Precautions Cardiovascular disease risk with Androgen Replacement is still unclear Androgen Replacement is not recommended for asymptomatic men or those with normal range Discontinue Testosterone Supplementation if no improvement after 3-6 months Androgen Replacement may be abused as an in sports Consider completing a III. Indications
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