To diagnose a patient as hypogonadal, the Endocrine Society recommends measuring serum testosterone twice. This double measurement is recommended because a significant percentage of men with an initial level of testosterone in the slightly hypogonadal range claim to have a normal testosterone level when the measurement is repeated. 26 Our study showed that 82.0% of men did not undergo two serum testosterone tests and 24.6% did not have a single serum testosterone test before starting Testosterone Replacement Therapy in Fort Lee NJ. Similarly, no serum testosterone test was observed in 48.0% of men within 12 months after the start of Testosterone Replacement Therapy in Fort Lee NJ. Although testosterone replacement therapy (TRT) is indicated to treat symptomatic hypogonadism, there is still controversy over whether TRT should be administered to middle-aged men to treat the clinical manifestations of andropause, regardless of whether serum levels of testosterone is low or not.
Side effects of TRT may include fluid retention, gynecomastia, polycythemia, and exacerbation of existing prostate cancer. As a result, patients treated with TRT require careful monitoring, including a periodic digital rectal exam and a serum prostate specific antigen (PSA) test. In the present document, we present the case of a middle-aged man with andropause and an increase in PSA during TRT. Because testosterone can stimulate prostate cancer, testosterone treatment is contraindicated in patients with known or suspected prostate cancer.
Men with severe congestive heart failure generally should not take a testosterone replacement, as it can worsen the condition. This blood test checks if you have the right level of thyroid hormones for a healthy metabolism. By age 80, more than 50% of men will have low testosterone levels (using a reference range defined by healthy, non-obese men under 40). An exhaustive meta-analysis of postmenopausal women found an improvement in sexual function with testosterone therapy.
Patients in the older age group (≥ 70 years old) were less likely to receive a serum PSA test than younger men. The odds of undergoing a serum testosterone test after starting treatment were significantly higher in patients treated by an endocrinologist (AOR=3.00, 95% CI: 2.80, 3.2) or by a urologist (AOR=1.84, 95% CI: 1.76, 1.9) than among those treated by other specialties, including primary care. Multivariable analyses showed that those consulted by an endocrinologist or urologist were more likely to receive appropriate tests. The FDA has mandated that manufacturers of testosterone products conduct a large scale randomized controlled trial specifically to determine cardiovascular risk38, but the results of any such trial will not be available until years.
This file contains the results of laboratory tests that were processed in one of the commercial laboratories that routinely transfer all results to the MDL. While the findings of the TOM trial are concerning, this study included a high-risk population and its findings may not be generalized to most men who are considering undergoing testosterone treatment. The normalization of testosterone levels is associated with a reduction in the incidence of myocardial infarction and mortality in men. Primary hypogonadism is the inability of the testicles to produce enough testosterone, while secondary hypogonadism is caused by decreased luteinizing hormone production.
Testosterone preparations are FDA Schedule III controlled substances that are subject to diversion and misuse. We will be happy to recommend a national network of clinics where you can take your test kit to have your blood drawn if necessary.
