Testosterone deficiency and treatments: common misconceptions and practical guidance for patient care.

IF 3.6 2区 医学 Q1 UROLOGY & NEPHROLOGY
Mohit Khera, James M Hotaling, Martin Miner
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引用次数: 0

Abstract

Introduction: Misconceptions about testosterone therapy are prevalent and there is an unmet need for a review of current literature that can be leveraged by physicians to deliver safe and effective care for men with hypogonadism.

Objectives: This review aims to address common misconceptions about testosterone therapy using current literature and synthesize practical guidance for clinicians with patients who are starting testosterone therapy.

Methods: A literature search of PubMed, Embase, CINAHL was carried out to identify associations between testosterone therapy and prostate cancer, cardiovascular risk, and hepatic toxicity; definitions of hypogonadism; and practical guidance for clinician with patients starting testosterone therapy.

Results: There is no evidence to support the misconception that testosterone therapy leads to or promotes progression of prostate cancer, no evidence that testosterone therapy increases cardiovascular risk, no evidence that newer oral testosterone therapy formulations (eg, testosterone undecanoate) are associated with hepatic toxicity, and no consistent definition of hypogonadism among regulatory agencies and expert bodies. Clinicians should diagnose hypogonadism using testosterone concentrations and/or symptoms of testosterone deficiency, help patients select a testosterone therapy formulation that best fits their needs and preferences (including considerations for dose adjustment), ensure appropriate laboratory monitoring before and during treatment, and assess how patients are feeling during treatment.

Conclusions: Testosterone therapy is not associated with increased prostate cancer or increased cardiovascular risk, newer oral testosterone therapy formulations are not associated with hepatic toxicity, and a strict definition of hypogonadism is difficult because patient individualization is required. Each patient in real-world clinical practices has unique baseline characteristics and will likely respond differently to testosterone therapy. As the primary goal of testosterone therapy is to provide relief from symptoms of hypogonadism, physicians should work with their male patients to create a comprehensive treatment plan that suits the patient's specific needs and preferences.

睾酮缺乏症与治疗:常见误解与患者护理实用指南。
导读:关于睾酮治疗的误解是普遍存在的,有一个未满足的需求,对现有文献的回顾,可以利用医生提供安全有效的护理男性性腺功能减退。目的:本综述旨在利用现有文献解决关于睾酮治疗的常见误解,并为临床医生开始睾酮治疗的患者提供实用指导。方法:检索PubMed、Embase、CINAHL的文献,以确定睾酮治疗与前列腺癌、心血管风险和肝毒性之间的关联;性腺功能减退的定义;为临床医生开始睾酮治疗提供实用指导。结果:没有证据支持睾酮治疗导致或促进前列腺癌进展的误解,没有证据表明睾酮治疗增加心血管风险,没有证据表明新的口服睾酮治疗配方(如十一酸睾酮)与肝毒性有关,监管机构和专家机构对性腺功能减退没有一致的定义。临床医生应使用睾酮浓度和/或睾酮缺乏症状诊断性腺功能减退,帮助患者选择最适合其需求和偏好的睾酮治疗方案(包括剂量调整的考虑),确保治疗前和治疗期间进行适当的实验室监测,并评估患者在治疗期间的感觉。结论:睾酮治疗与前列腺癌增加或心血管风险增加无关,较新的口服睾酮治疗配方与肝毒性无关,性腺功能减退的严格定义是困难的,因为需要患者个体化。在现实世界的临床实践中,每个患者都有独特的基线特征,可能对睾酮治疗有不同的反应。由于睾酮治疗的主要目标是缓解性腺功能减退的症状,医生应该与他们的男性患者一起制定一个适合患者特定需求和偏好的综合治疗计划。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Sexual medicine reviews
Sexual medicine reviews UROLOGY & NEPHROLOGY-
CiteScore
7.60
自引率
8.30%
发文量
5
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