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afya
Testosterone
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Testosterone deficeincy - ? normal ageing or ?disorder Primary hypogonadism - testicular failure Secondary hypogonadism - pituitary / hypothalamus disorder Late onset hypogonadism - some primary and secondary - inc with age, alcohol, steroids, disease (liver / renal failure) Androgen insensitivity Testing - always repeat abN, <8 - replace, >12 don't ..... Testosterone levels fluctuate - fasting, alcohol, diurnal rhythm Binding - SHBG (inc with age) unusable SHBG - inc with hyperthyroid, liver disease, androgen deficiency, oestrogen xs If Testos low - check LH FSH and prolactin Sx slowed hair growth - axillae, genitals, beard dec muscle and inc fat dec libido, erectile dysfunction, oligospermia lethargy, mood changes Erectile dysfunction - most commonly - diabetes and CVD Low Testos Osteoporosis Diabetes CVD Dementia / depression treat - mostly as to Sx NOT as to testos levels short term (6/12) course and review may be useful use tabs (qds) injection (weekly), implant etc pre-Rx - check PSA - testos may exacerbate prostate cancer but not thought to initiate it - if any Sx or raised PSA - refer to urologist prior to testos Rx during Rx - monitour - testos (timing), PSA, bone density, FBC (3,6,12 mthly then yrly)
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ReproductiveMetabolic