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Grand Rounds in Urology, Volume 7, Issue 3 |
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Hypogonadism affects several million men in the United States, its prevalence increases with age, and it is underdiagnosed and undertreated. Reasons for underdiagnosis and undertreatment are numerous. First, signs and symptoms of low testosterone are often subtle and nonspecific. Second, a consensus on the definition of low testosterone has not been established. Many commercially available assays for the measurement of testosterone levels have not been standardized, resulting in considerable variability among laboratories in reference values for identifying low testosterone levels.
It is important to understand these challenges to optimize patient outcomes with the benefits of testosterone therapy. Additionally, low testosterone has been associated with insulin resistance, metabolic syndrome, diabetes, and other chronic co- morbid conditions. A recent study reports that testosterone therapy improved insulin resistance and glycemic control in hypogonadal men with type 2 diabetes. Unfortunately, few large randomized clinical trials adequately address prostate safety during long-term testosterone therapy. Many testosterone therapies are currently marketed, but a safe, efficacious formulation that more closely mimics endogenous testosterone is still needed. This conference presents data and expert opinion to address the underdiagnosis and undertreatment of hypogonadism and to provide clinicians with strategies for treating patients with hypogonadism, including testosterone therapy.
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