Testosterone replacement therapy: role of pituitary and thyroid in diagnosis and treatment

Crawford, Megan R.; Kennedy, Laurence

doi:10.21037/tau.2016.09.01

Cited by 11 publications

(7 citation statements)

References 67 publications

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“…Treatment for decrease in testosterone levels can use testosterone replacement therapy, namely testosterone injection. 13 Our patient had decreased testosterone levels (2.0 ng/mL), along with low FSH and LH followed by the presence of a pituitary microadenoma in the patient. This patient was male and unmarried so the patient was given 250 mg of testosterone replacement injection every month.…”

Section: Case Reportmentioning

confidence: 61%

Diagnostic challenges and management a patient with micropenis and pituitary microadenoma

Pridanta¹,

Ardiany²

2022

Bali Med J.

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Background: Micropenis is a condition where the penis size is smaller than 2.5 standard deviation on average without any anatomical malformations. Hypogonadotropic hypogonadism is one of the causes of micropenis and one of the structural disorders that could lead to hypogonadotropic hypogonadism is a pituitary microadenoma that alters the levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH) and testosterone. In this case-report we present a patient with micropenis caused by pituitary adenoma. Case presentation: A 40-year-old male patient, presented to Dr Soetomo Hospital with a chief complaint of having a small penis that did not match the proportions of the body but could still erect and ejaculate. The patient experienced fatigue for about two months before the admission and struggled to concentrate while walking for the last six months. The laboratory results were hyperprolactinemia, hypo albumin, and dyslipidemia. From the MRI examination with contrast, a mass was found in the left pituitary. The patient was diagnosed with pituitary microadenoma, hypogonadotropic hypogonadism, micropenis, hypotestosterone, hypocortisolism, and hypothyroidism. The patient was assigned for monthly monitoring. Consultation with a neurosurgeon suggested there were no indications for surgery. The patient was treated with testosterone intramuscular injection 250 mg every month, methylprednisolone 4 mg every 8 h, simvastatin 20 mg every 24 h, and levothyroxine sodium 50 mg every 24 h. One month follow up, fatigue was disappeared and nine months follow up found improvements in hormone levels and balance during walking. Conclusion: Pituitary microadenoma can manifest as micropenis, hypocortisolism, and shift hormone levels. The main therapy for pituitary microadenoma is hormone therapy as presented this present case report.

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Section: Case Reportmentioning

confidence: 61%

Diagnostic challenges and management a patient with micropenis and pituitary microadenoma

Pridanta¹,

Ardiany²

2022

Bali Med J.

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“…Besides, individuals with a very high or very low level of testosterone are strongly associated with health status ( 46 , 47 ). Some diseases, such as pituitary disorders ( 48 ), HIV ( 49 ), and hyperthyroidism ( 50 ), as well as obesity ( 51 ), may interfere the testosterone production, increasing the possibility of extreme level of occurrence. It is worth noting that these diseases have a possible influence on personal health span as well.…”

Section: Discussionmentioning

confidence: 99%

Sex-Specific Associations of Testosterone and Genetic Factors With Health Span

et al. 2021

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BackgroundPrevious studies have suggested associations between testosterone, genetic factors, and a series of complex diseases, but the associations with the lifespan phenotype, such as health span, remain unclear.MethodsIn this prospective cohort study, we analyzed 145,481 men and 147,733 women aged 38–73 years old from UK Biobank (UKB) to investigate the sex-specific associations of total testosterone (TT), free testosterone (FT), or polygenic risk score (PRS) with health span termination (HST) risk. At baseline, serum testosterone levels were measured. HST was defined by eight events strongly associated with longevity. PRS, an efficient tool combining the effect of common genetic variants to discriminate genetic risk of complex phenotypes, was constructed by 12 single-nucleotide polymorphisms related to health span from UKB (P ≤ 5.0 × 10−8). We used multivariable Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).ResultsWith a median follow-up time of 7.70 years, 26,748 (18.39%) men and 18,963 (12.84%) women had HST. TT was negatively associated with HST in men [HR per standard deviation (SD) increment of log-TT: 0.92, 95% CI: 0.88–0.97]. Inversely, both TT (HR per SD increment of log-TT: 1.05, 95% CI: 1.02–1.08) and FT (HR per SD increment of log-FT: 1.08, 95% CI: 1.05–1.11) presented an increased risk of HST in women. PRS was positively associated with HST risk (quintile 5 versus quintile 1, men, HR: 1.19, 95% CI: 1.15–1.24; women, HR: 1.21, 95% CI: 1.16–1.27). Moreover, men with high TT and low genetic risk showed the lowest HST risk (HR: 0.80, 95% CI: 0.73–0.88), whereas HST risk for women with both high TT and genetic risk increased obviously (HR: 1.32, 95% CI: 1.19–1.46). Similar joint effects were observed for FT in both genders.ConclusionsWe observed sex-specific associations that testosterone was negatively associated with HST risk in men and positively associated with HST risk in women. Genetic factors increased the HST risk, suggesting that participants with both high genetic risk and abnormal testosterone levels (high level in women or low level in men) should be the target for early intervention. Although our findings highlight the associations between testosterone and health span, further mechanistic studies and prospective trials are warranted to explore the causation behind.

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“…Dichos significados influyeron también en sus perspectivas respecto al impacto sexual de la enfermedad. Que el cambio de mayor afectación para los varones fueran las dificultades con la erección se relacionó con su significado de cuestionamiento a la identidad masculina hegemónica (González, 2010), aunque debe considerarse que es el trastorno más frecuentemente referido en esta población (Bates et al, 2020;Crawford & Kennedy, 2016). En las mujeres, el énfasis en la disminución del deseo sexual y el impacto estético de estas enfermedades es similar a resultados obtenidos en otros estudios (Cintra et al, 2018;Krysiak et al, 2016;Pastoor et al, 2018).…”

Section: Discussionunclassified

Sexualidad en el contexto de los procesos de vida de mujeres y varones con endocrinopatías: una aproximación cualitativa

Llanes¹,

Torres-Rodríguez

Turcios-Tristá³

et al. 2020

Liberabit

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Antecedentes: las enfermedades del sistema endocrino pueden afectar la sexualidad por sus efectos hormonales, las comorbilidades asociadas y su impacto psicosocial, tema poco estudiado desde las perspectivas de personas con estas enfermedades. Objetivos: se realizó un estudio cualitativo dirigido a comprender las experiencias sexuales de mujeres y varones con enfermedades endocrinas que producen cambios en la apariencia física. Método: se estructuró un diseño de estudio analítico-interpretativo. Participaron 68 personas entre 20 y 45 años de edad, atendidos en el Instituto Nacional de Endocrinología, La Habana, Cuba. Los instrumentos de recolección de la información utilizados fueron una planilla de datos generales, una guía de entrevista en profundidad y dos pruebas psicológicas proyectivas. Los aspectos éticos fueron considerados. Resultados: de las entrevistas en profundidad, emergieron 4 temas: 1) la expresión multidimensional de la enfermedad, 2) enfermedad y áreas de vida, 3) ejercicio de la sexualidad con la enfermedad, y 4) estrategias de afrontamiento en el área sexual; vinculados con los significados expresados sobre la salud, el cuerpo, el género y la sexualidad. Conclusiones: las/los participantes contextualizaron sus experiencias sexuales en el impacto biopsicosocial de la enfermedad. La reproducción o cuestionamiento de los significados expresados influyó en la calidad de sus experiencias sexuales. El estudio mostró que esta constituye un área de vulnerabilidad para la salud integral de las/los participantes.

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Testosterone replacement therapy: role of pituitary and thyroid in diagnosis and treatment

Cited by 11 publications

References 67 publications

Diagnostic challenges and management a patient with micropenis and pituitary microadenoma

Diagnostic challenges and management a patient with micropenis and pituitary microadenoma

Sex-Specific Associations of Testosterone and Genetic Factors With Health Span

Sexualidad en el contexto de los procesos de vida de mujeres y varones con endocrinopatías: una aproximación cualitativa

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