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Friday, 19 Oct 2018

Testosterone Deficiency (Hypogonadism)

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Levels of serum testosterone (T) in men decline markedly with age largely due to decreased production of T by the testes. Concurrently, the levels of sex hormone binding globulin (SHBG) increase with age causing the unbound or free T levels to fall even more than the overall T. Up to 30% of men in their 40s are testosterone deficient and this percentage increases with age.

Testosterone deficiency is significantly associated with various diseases such as obesity, type 2 diabetes, hypertension, osteoporosis and the metabolic syndrome.

The main symptoms of T deficiency include:

  • Reduced libido 
  • Erectile dysfunction 
  • Reduced muscle mass and strength 
  • Increased fat mass 
  • Osteoporosis/low bone density 
  • Depressed mood 
  • Fatigue

Diagnosis of the condition requires the presence of low serum testosterone levels and the presence of hypogonadal symptoms.

Restoration of testosterone levels to the normal range improves libido, sexual function and mood, improves cognition, reduces body fat mass, increases lean body mass and improves bone mineral density.

There are a number of formulations available for testosterone replacement therapy including: intramuscular injections, transdermal patches, transdermal gels (most commonly used), buccal patches and subcutaneous pellets.