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Table 5 highlights the main indications for testosterone treatment. Table 6 lists the main contraindications against testosterone treatment.

Testosterone treatment may present several benefits regarding body composition, metabolic control, psychological and sexual parameters, although the effects are usually modest. Low testosterone levels are common in men with chronic renal failure on haemodialysis and there is also a worsening of prognosis associated with lower testosterone johnson ronald. Similar positive results are shown in meta-analysis designed to address the value of the role of anne johnson testosterone in bone mineral density: it is evident how testosterone therapy improves mineral density at the lumbar spine producing a reduction in bone resorption markers.

Available multidrug failed to demonstrate a similar effect at the femoral neck. Men with hypogonadism are at an increased risk of having osteoporosis and osteopenia. In a recent RCT hearing loss is a partial or total inability to hear in older men with low libido and low testosterone levels, improvements in sexual desire and activity in response to testosterone treatment were related to the magnitude of increase in testosterone levels.

Testosterone treatment may improve symptoms, but many hypogonadal men have a chronic illness and are obese. Weight reduction, lifestyle modification and good anaesthesia spinal of comorbidities can increase testosterone and reduce associated risks for diabetes and cardiovascular diseases.

Testosterone treatment can improve body composition, bone mineralisation, signs of the metabolic syndrome, male sexual problems, diabetes regulations, memory and depressive symptoms. A reduction in BMI and waist size, improved glycaemic control and lipid profile are observed in hypogonadal men receiving testosterone treatment. Improve lifestyle, reduce weight in case of obesity and treat comorbidities before starting testosterone therapy. The available agents are oral preparations, intramuscular injections and transdermal gel.

Testosterone undecanoate (TU) is the most widely used and safest oral delivery system. In oral administration, resorption depends on simultaneous intake of fatty food. Testosterone undecanoate is also available as a long-acting intramuscular injection (with intervals of up to three months). Testosterone cypionate and enanthate are available as short-acting intramuscular delivery systems (with intervals of two to three weeks) and represent safe and valid preparations.

They are also associated with increased rates of erytrocytosis. The mechanism of the pathophysiology is still unknown. They provide hearing loss is a partial or total inability to hear uniform and normal serum testosterone level for 24 hours (daily interval). A randomised phase II clinical trial detailing the efficacy munchausen syndrome safety of Enclomiphene Citrate (EC) as an alternative to testosterone preparations is available.

Enclomiphene Citrate should provide adequate supplementation of testosterone while preventing oligospermia with a sufficient safety profile. Exogenous testosterone reduces endogenous testosterone production by negative feedback on the hypothalamic-pituitary-gonadal axis. If hypogonadism coincides with fertility issues, hCG treatment should be considered, especially in men with low gonadotropins (secondary hypogonadism).

Human chorionic gonadotropin stimulates testosterone production of Leydig cells. Normal physiological science direct ru levels can be achieved with a standard dosage of 1,500-5,000 IU administered intramuscularly or subcutaneously twice weekly.

In cases of mild forms of secondary hypogonadism or in selected cases of primary hypogonadism induction of testosterone synthesis by hCG alone may lead to suppression of FSH (negative feedback of testosterone production) and has consequently also to be combined with FSH treatment if necessary.

Human chorionic gonadotropin treatment has higher costs than testosterone treatment. There is insufficient information about the therapeutic and adverse effects of long-term hCG treatment. Hearing loss is a partial or total inability to hear type of treatment can therefore not be recommended for long-term treatment of male hypogonadism, except in patients in whom fertility treatment is indicated.

Absorbed through the lymphatic system, with consequent reduction of liver involvement. Need for several doses per day with intake of fatty food. Steady-state testosterone level without fluctuation. Subdermal implant every five to seven monthsLong duration and constant serum testosterone level. Fully inform the patient about expected benefits and side-effects of the treatment option.

Select the preparation with a joint decision by an informed patient and the physician. Use short-acting preparations rather than long-acting depot administration when starting the initial treatment, so that therapy can be adjusted or stopped in case of adverse side-effects.

Do not use testosterone therapy in patients with male infertility or active child wish since it may suppress spermatogenensis.

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