Testosterone deficiency and replacement therapy in men

The clinical vignette depicted a 52 year old man of Caucasian descent who presented with erectile dysfunction, diminished libido and fatigue. He was 5 feet, 7 inches tall, weighed 217 pounds and had normal blood and laboratory values, except that his blood pressure was high and his serum total testosterone was low and his fasting serum glucose and lipid profiles were high –indicating the presence of metabolic syndrome.

In conclusion, the authors recommend that the man be treated for 2-3 months using TRT, with a follow up to determine the efficacy of the TRT in increasing his testosterone levels to normal levels. Their recommendations are in agreement with many published guidelines and show that the TRT treatment, in conjunction with diet and exercise, will help improve the man's sexual and physical health.

"This clinical vignette offers important information for general practitioners and provides practical recommendations for diagnosing TD and the novel treatment approaches that could positively impact the overall health of middle-aged men," said Traish.

By introducing the clinical vignette as a teaching case study the authors re-focused the attention on utilizing not only blood (serum) test for testosterone, but also taking into account the sexual and non-sexual physical symptoms into considerations. The authors also indicated that current data failed to show a significant association between TRT and prostate cancer. TRT has been shown to improve sexual function in men with TD. According to a recent review article in the American Journal of Medicine, TRT might also improve the overall health of men.

Provided by Boston University Medical Center