Diagnosis and management of testosterone deficiency syndrome in men: clinical practice guideline

Reproductive Health of Men with Spinal Cord Injury

“…Hypogonadism puts men at risk for sexual dysfunction and infertility, cardiovascular-related events, and fracture from osteoporosis 2 ; men with SCI are already at risk for these conditions. Low testosterone is observed in 39% to 46% of men with SCI, and it is related to increased fat mass and duration of severity of injury.…”

“…Low testosterone can also occur within the first year of injury as a result of dysfunction of the hypothalamic-pituitarygonadal axis secondary to SCI. 3 Other causes of low testosterone found in the general population, including head injury, obesity, diabetes, metabolic syndrome, and hyperlipidemia, 2 can also contribute to low testosterone in men with SCI because they are prone to these comorbidities. Persons with sleep apnea or disordered breathing (almost 60% in persons with complete quadriplegia) 5 are also at risk for low testosterone.…”

“…Persons with sleep apnea or disordered breathing (almost 60% in persons with complete quadriplegia) 5 are also at risk for low testosterone. Replacing serum testosterone levels to eugonadal levels with proper monitoring 2 is of benefit to men with chronic SCI in terms of improved sexual drive, erection function, energy, mood, muscle strength, and body composition. Forms of gonadotropin stimulation can be used in men who want to have children.…”

Recommendations for followup of stage I and II seminoma: The Princess Margaret Cancer Centre approach

“…26 Hypogonadal symptoms associated with consistently low testosterone levels may be managed with testosterone replacement and referral to endocrinology. 27 A brief psychosocial review is performed to screen for underlying anxiety and depression. 28,29 Men with testicular cancer may have increased rates of anxiety and suicide compared to the general population.…”

Addressing the pressing issues related to testosterone administration to men with prostate cancer

“…It is also timely because it is apparent that there is a significant amount of confusion and inconsistency among clinicians as to the appropriateness and safety of testosterone administration in general and to men with a history of PCa in particular. 2 There are two important distinctions regarding the administration of testosterone to hypogonadal men with PCa: 1) those who have been treated with curative intent; and 2) those on active surveillance. For the former, limited but accumulating evidence indicates that judicious administration of testosterone is safe.…”