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Perspectives

Testosterone therapy in men: ongoing management and surveillance

Carolyn A Allan

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Abstract

Men with testicular or hypothalamo-pituitary disease who are taking testosterone replacement therapy can expect to remain on treatment lifelong. Appropriate surveillance protocols therefore need to be established to ensure the reversal of existing manifestations of androgen deficiency and to monitor for potential adverse effects of treatment.

Key Points

  • Men with proven testosterone deficiency can expect to remain on therapy lifelong.
  • Assessment of men receiving testosterone therapy includes digital rectal examination; full blood exam; dual-energy x-ray absorptiometry; measurement of prostate-specific antigen, lipids and fasting blood glucose levels; and a sleep assessment. These should occur at baseline and then according to consensus protocols and individual risk profiles.
  • Measurement of serum testosterone levels in men treated with testosterone should be interpreted in the context of the mode of testosterone administration.
  • Testosterone therapy should not be administered to men who desire fertility.

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