Some new articles

[BigJimCalhoun]

http://www.ncbi.nlm.nih.gov/pubmed/18163948?ordinalpos=6&itool=EntrezSystem2.PEntrez. Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
Androgen deficiency in the aging male: a guide to diagnosis and testosterone replacement therapy.

Raynor MC, Carson CC, Pearson MD, Nix JW.
Department of Urology, Tulane University Health Sciences Center, New Orleans, LA, USA.
A steady decline in androgen levels occurs in males as they age. Evidence suggests that this decline may be at least partially responsible for a variety of physical and mental changes associated with the aging process. For instance, abnormally low levels of androgens can lead to profound changes in bone density, body composition, as well as sexual and cognitive function. Testosterone replacement has been shown to produce improvements in many of these areas. However, this practice is not without risks, both proven and theoretic. Also, the diagnosis of androgen deficiency and the decision to treat is not always straightforward. The purpose of this article is to familiarize the clinician with issues associated with androgen deficiency in the aging male. The clinical symptoms of androgen deficiency as well as the risks and benefits of androgen replacement will be discussed. This should help clinicians better identify those patients in whom testosterone replacement therapy should be considered.


http://www.ncbi.nlm.nih.gov/pubmed/18225457?ordinalpos=9&itool=EntrezSystem2.PEntrez. Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
The many faces of testosterone.

Bain J.
Department of Medicine, Department of Obstetrics and Gynecology, University of Toronto, Ontario, Canada. j.bain@utoronto.ca
Testosterone is more than a "male sex hormone". It is an important contributor to the robust metabolic functioning of multiple bodily systems. The abuse of anabolic steroids by athletes over the years has been one of the major detractors from the investigation and treatment of clinical states that could be caused by or related to male hypogonadism. The unwarranted fear that testosterone therapy would induce prostate cancer has also deterred physicians form pursuing more aggressively the possibility of hypogonadism in symptomatic male patients. In addition to these two mythologies, many physicians believe that testosterone is bad for the male heart. The classical anabolic agents, 17-alkylated steroids, are, indeed, potentially harmful to the liver, to insulin action to lipid metabolism. These substances, however, are not testosterone, which has none of these adverse effects. The current evidence, in fact, strongly suggests that testosterone may be cardioprotective. There is virtually no evidence to implicate testosterone as a cause of prostate cancer. It may exacerbate an existing prostate cancer, although the evidence is flimsy, but it does not likely cause the cancer in the first place. Testosterone has stimulatory effects on bones, muscles, erythropoietin, libido, mood and cognition centres in the brain, penile erection. It is reduced in metabolic syndrome and diabetes and therapy with testosterone in these conditions may provide amelioration by lowering LDL cholesterol, blood sugar, glycated hemoglobin and insulin resistance. The best measure is bio-available testosterone which is the fraction of testosterone not bound to sex hormone binding globulin. Several forms of testosterone administration are available making compliance much less of an issue with testosterone replacement therapy.
PMID: 18225457 [PubMed - indexed for MEDLINE]

[BigJimCalhoun]

The aging male - diagnosis and therapy of late-onset hypogonadism.

Schreiber G, Ziemer M.
Department of Dermatology and Allergology, University Clinic of Jena, Friedrich Schiller University, Jena, Germany.
Managing the clinical features of hormone insufficiency in aging men is an important field of activity for dermatologists and in particular for dermatologists specialized in andrology. Potential consequences of age-associated decrease in plasma testosterone levels include long-term changes in diverse organ systems including changes of bone architecture, body composition, muscular strength, cognitive functions, and mood as well as negative effects on skin and hair. Indications and contraindications for a hormone replacement therapy as well as therapy monitoring are well-defined. Replacement of testosterone in the case of late-onset hypogonadism is not a standardized therapy. Previous studies suggest that testosterone replacement therapy has positive clinical effects. Dermatologic effects of testosterone replacement therapy have not yet been investigated. Further research is required to identify potential benefits and risks of hormone replacement therapy in aging men.


[The testosterone therapy in patients with andropause]

[Article in Polish]


Krysiak R, Okopień B, Gdula-Dymek A.
Kliniki Chorób Wewnetrznych i Farmakologii Klinicznej Katedry Farmakologii Slaskiego Uniwersytetu Medycznego w Katowicach. r.krysiak@pharmanet.com.pl
Andropause affects millions of men worldwide. The importance of this condition results not only from the aging process in contemporary societies, but also from raising awareness concerning its causes and symptoms. In recent years, the pathogenesis, diagnosis and treatment of andropause have been better known. The huge progress made in better understanding of this condition has thrown a new light on the management of patients with andropause. Unfortunately, the results of so far conducted studies are incoherent what makes it difficult to establish indications for the therapy and the time of beginning of testosterone supplementation. Apart from providing the reader with the scheme of treatment, the paper is aimed to discuss potentially beneficial and harmful effects of testosterone supplementation on various organs and life functions altered by age-related changes.


The latest options and future agents for treating male hypogonadism.

Edelstein D, Sivanandy M, Shahani S, Basaria S.
Johns Hopkins University School of Medicine, Division of Endocrinology and Metabolism, Bayview Medical Center, 5200 Eastern Avenue, Mason F Lord Building, 4th Floor, Suite 4300, Baltimore, Maryland 21224, USA.
Exogenous testosterone has long been used in medicine as a pharmaceutical agent. Its use in hypogonadism is well characterized and its development as a drug has undergone several modifications in an attempt to achieve clinical success. As native testosterone is rapidly degraded, modified analogs have been developed to obtain a better pharmacokinetic profile. The developmental goals of testosterone analogs have evolved since its first introduction as an orally available form to longer acting and more stable forms such as injectables, depots and transdermal therapies. Several modalities of testosterone replacement are presently available, each differentiated by their route of delivery, half life, cost and ability to deliver physiologic levels of testosterone. As hypogonadism is often a life-long condition, physicians are compelled to use an appropriate therapy that best matches the needs of their patients. An ideal testosterone therapy should be able to deliver physiologic levels of testosterone and be safe, simple to use and cost effective. Present trends show transdermal therapies (gels and patches) along with long-acting injectables, such as Nebido, are quickly replacing intramuscular testosterone modalities. Compounds such as dihydrotestosterone, human chorionic gonadotropin, aromatase inhibitors and clomiphene are presently being studied in specific subgroups of men. Additionally, several new compounds, such as selective androgen-receptor modulators and 7-alpha-methyl-19-nortestosterone, are being developed to target androgen receptors in specific tissues. A further understanding of the androgen receptor and subsequent discovery of targeted drugs may yield more individualized treatment modalities. This will enhance the effectiveness of available therapies, while mitigating their undesirable effects.
PMID: 18001258 [PubMed - indexed for MEDLINE]


Jones TH.
Centre for Diabetes and Endocrinology, Barnsley Hospital NHS Foundation Trust, Barnsley.
Hypgonadism has important adverse effects on the health and quality of life of affected men, but remains underdiagnosed in clinical practice. This article reviews the physiology, causes and diagnosis of hypogonadism and the potential benefits of treatment with testosterone replacement therapy.
PMID: 17974303 [PubMed - indexed for MEDLINE]

[BigJimCalhoun]

Recent trends in the treatment of testosterone deficiency syndrome.

Hong BS, Ahn TY.
Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Poongnap-dong, Sonpa-gu, Seoul, Korea.
Testosterone deficiency syndrome (TDS) is defined as a clinical and biochemical syndrome associated with advancing age and is characterized by typical symptoms and deficiency in serum testosterone levels. TDS is a result of the interaction of hypothalamo-pituitary and testicular factors. Now, treatment of TDS with testosterone is still controversial due to a lack of large, controlled clinical trials on efficacy. The risks of treatment with testosterone appear to be minimal, although long-term studies on the safety of testosterone therapy are lacking. The aim of the therapy is to establish a physiological concentration of serum testosterone in order to correct the androgen deficiency, relieve its symptoms and prevent long-term sequelae. All of the available products, despite their varying pharmacodynamic and pharmacokinetic profiles, are able to reach this goal. Newer testosterone patches seem not to cause severe skin irritation. Testosterone gels minimize the skin irritation while providing flexibility in dosing and a low discontinuation rate. Oral testosterone undecanoate (TU) is free of liver toxicity. Recent formulation of oral TU markedly increased shelf-live, a major drawback in the older preparation. Producing swings in testosterone levels rising rapidly to the supraphysiological range is not the case with the new injectable long-acting preparation of TU. To be able to rapidly react and stop treatment in cases where side-effects and contraindications are detected, the short-acting transdermal and oral delivery modes have certain advantages. However, there is no evidence that the use of an injectable long-acting TU in men with TDS has limitations in clinical application for this reason. The use of dehydroepiandrosterone is still controversial because of a lack of well designed long-term trials, although some recent studies suggest positive effects on various body systems. Only a few studies have been carried out to investigate the effect of hCG (human chorionic gonadotropin) in TDS with some positive results on various body systems.
PMID: 17956520 [PubMed - indexed for MEDLINE]

[Blut Wump]

Thanks

[buzz]

+1

[mnk]

+ 1

[solidspine]

Androgen deficiency in the aging male: a guide to diagnosis and testosterone replacement therapy.

Exactly, but tell this to the DEA & FDA, Barry Bonds tried to tell them, they would not listen,


The Government wants us to die of low test.


Where is Che when he is needed?

[ModestGainz]

Good info. Thanks for putting it up.

[Killer]

Thanks from me too!