Note: Page numbers of article titles are in boldface type. A Acquired hypogonadism, prevalence of, 165 167 primary, 165 secondary, 167 Adipose tissue, as an organ, 240 241 Adrenal hyperplasia, congenital, hypogonadism due to, 197 Age, role in low testosterone and sleep apnea, Androgen hypothesis, of prostate cancer, 210 Androgen insensitivity syndrome, 157 158 Androgens, effects of fat on, 241 242 effects of, on fat, 242 Aromatase inhibitors, to raise endogenous Assays, of serum testosterone, 177 184 B Benign prostatic hyperplasia, testosterone and, Body mass index, role in low testosterone and sleep apnea, Buccal formulations, of testosterone, 187 C Cancer, prostate. See Prostate cancer. Cardiovascular patients, management of hypogonadism in, 247 260 clinical diagnosis and management of hypogonadism, 248 249 clinical manifestations of testosterone deficiency, 249 250 adverse symptoms and physiologic consequences, 249 increase in metabolic syndrome and other risk factors, 249 increased all-cause and cardiovascular mortality, 249 250 effects of testosterone replacement therapy, 250 254 prospective data, 250 252 retrospective data, 252 254 Urol Clin N Am 43 (2016) 273 277 http://dx.doi.org/10.1016/s0094-0143(16)00026-4 0094-0143/16/$ see front matter Ó 2016 Elsevier Inc. All rights reserved. natural history of testosterone levels, 248 other therapeutic options, 255 role of testosterone in cardiovascular disease, 254 255 Clomiphene citrate supplementation, effect on sexual function, 220 Congenital adrenal hyperplasia, hypogonadism due to, 197 Congenital hypogonadism, prevalence of, 164 167 D Diagnosis, of hypogonadism, 168 170, 178 179 assays of serum testosterone, 177 184 laboratory analysis, 170 173 selection for screening, 168 semen analysis, 173 Dihydrotestosterone, and the prostate, 203 208 E Ejaculatory function, effect of testosterone supplementation on, 220 Embryology, of the prostate, 203 204 Endogenous testosterone, lifestyle interventions to raise, 190 Epidemiology, of hypogonadism, 167 168 Erectile function, effect of testosterone supplementation on, 218 219 Exogenous testosterone. See also Testosterone therapy. hypogonadism and, 198 200 F Fatigue, role in low testosterone and sleep apnea, urologic.theclinics.com
274 Follicle stimulating hormone (FSH), and testicular function, 152 153 Food and Drug Administration (FDA), actions on testosterone supplements, 268 269 G Gels, testosterone, 187 Genetic defects, hypogonadism due to, 196 197 Gonadotropins, normal hypothalamic regulation of, 152 H Human chorionic gonadotropin (hcg), effect on sexual function, 220 to raise endogenous Hyperestrogenemia, hypogonadism due to, 197 Hyperprolactinemia, hypogonadism due to, 197 Hypogonadism, 151 271 assays of serum testosterone, 177 184 intraindividual, 179 180 in cardiovascular patients, 247 260 clinical diagnosis and management of hypogonadism, 248 249 clinical manifestations of testosterone deficiency, 249 250 effects of testosterone replacement therapy, 250 254 natural history of testosterone levels, 248 other therapeutic options, 255 role of testosterone in cardiovascular disease, 254 255 male infertility and testosterone, 195 202 causes of, 195 198 congenital adrenal hyperplasia, 197 hyperestrogenemia, 197 hyperprolactinemia, 197 hypogonadotropic, 196 197 Klinefelter syndrome, 197 198 exogenous testosterone and, 198 mass spectrometry, 181 183 obesity and, 239 245 adipose tissue as an organ, 240 241 effects of obesity treatment on testosterone, 242 243 effects of testosterone treatment on obesity, 243 hypogonadism as an endocrine disease, 241 interplay between, 241 242 physiology of hypothalamic pituitary gonadal axis, 151 162 abnormalities of testicular function, 158 anatomic overview, 152 androgen sensitivity syndrome, 157 158 control of hypothalamic secretion, 152 diagnosis, 158 159 FSH, LH, and testicular function, 152 153 hypogonadotropic, 155 157 normal hypothalamic regulation of gonadotropins, 152 novel therapeutics, 159 161 peripheral metabolism of testosterone, 153 155 sexual development in males, 155 treatment, 159 prevalence and diagnosis, 163 176 diagnosis, 168 170 laboratory analysis, 170 173 selection for screening, 168 semen analysis, 173 epidemiology, 167 168 acquired, 167 168 sexual function and testosterone supplementation, 217 222 and phosphodiesterase type 5 inhibitors, 220 sleep apnea and, 233 237 effects on testosterone level, 235 role of fatigue, testosterone deficiency and the prostate, 203 208 embryology of the prostate, 203 204 testosterone and prostate cancer, 206 testosterone and prostate growth, 204 testosterone therapies, 185 193
275 adverse events with, 190 191 alternatives to, 190 and prostate cancer, 209 216 in men with history of prostate cancer, 212 213 contraindications, 186 follow-up and monitoring, 191 history, 185 186 lifestyle interventions to raise endogenous pretreatment considerations, 186 treatment options, 186 190 buccal formulations, 187 gels and solutions, 187 long-acting injections, 189 oral preparations, 189 patches, 189 190 short-acting injections, 189 subcutaneous pellets, 189 trends in testosterone prescription, 261 271 varicocele and testosterone, 223 232 clinical data, 223 226 pathophysiology of Leydig cell dysfunction, animal studies, 228 human studies, 226 227 varicocelectomy for, 228 229 Hypogonadotropic hypogonadism, 155 157, 196 197 Kallmann syndrome, 196 other genetic causes, 197 Prader-Willi syndrome, 196 197 Hypothalamic pituitary gonadal axis, physiology of, 151 162 abnormalities of testicular function, 158 anatomic overview, 152 androgen sensitivity syndrome, 157 158 control of hypothalamic secretion, 152 diagnosis, 158 159 FSH, LH, and testicular function, 152 153 hypogonadotropic, 155 157 normal hypothalamic regulation of gonadotropins, 152 novel therapeutics, 159 161 peripheral metabolism of testosterone, 153 155 sexual development in males, 155 treatment, 159 Hypothalamus, anatomy overview, 152 I Immunoassays, for measuring total testosterone, 180 181 Infertility, male, 195 202 causes of hypogonadism, 195 198 congenital adrenal hyperplasia, 197 hyperestrogenemia, 197 hyperprolactinemia, 197 hypogonadotropic, 196 197 Kallmann syndrome, 196 other genetic causes, 197 Prader-Willi syndrome, 196 197 Klinefelter syndrome, 197 198 exogenous testosterone and, 198 Injections, of testosterone, 189 long-acting, 189 short-acting, 189 K Kallmann syndrome, hypogonadism in, 196 Klinefelter syndrome, hypogonadism due to, 197 198 L Laboratory testing, for hypogonadism, 170 173 Leydig cell dysfunction, pathophysiology of, Libido, effect of testosterone supplementation on, 219 Lifestyle interventions, to raise endogenous Luteinizing hormone (LH), and testicular function, 152 153 M Male infertility. See Infertility, male. Mass spectrometry, for measuring total testosterone, 181 182
276 Middle age, testosterone and prostate growth in, 204 O Obesity, and hypogonadism, 239 245 adipose tissue as an organ, 240 241 effects of obesity treatment on testosterone, 242 243 effects of testosterone treatment on obesity, 243 hypogonadism as an endocrine disease, 241 interplay between, 241 242 effects of androgens on fat, 242 effects of fat on androgens, 241 242 Obstructive sleep apnea, testosterone deficiency and, 233 237 effects of apnea treatment on testosterone level, 235 role of fatigue, Old age, testosterone and prostate growth in, 204 Oral preparations, of testosterone, 189 Orgasm, effect of testosterone supplementation on, 220 P Patches, testosterone, 189 190 Pellets, subcutaneous testosterone, 189 Pharmacy sales, of testosterone supplement products, 262 263 Phosphodiesterase type 5 inhibitors, effect of testosterone supplementation on, 220 Pituitary, anatomy overview, 152 Polycythemia, obstructive sleep apnea and, 235 236 Prader-Willi syndrome, hypogonadism in, 196 197 Prescribing practices, for testosterone supplementation therapy, 261 271 Prevalence, of hypogonadism, 163 176, 178 epidemiology, 167 168 acquired, 167 168 Primary hypogonadism, prevalence of, 164 165 Prostate, testosterone deficiency and, 203 208 embryology of, 203 204 testosterone and prostate cancer, 206 testosterone and prostate growth, 204 Prostate cancer, testosterone and, 206 testosterone therapy and, 209 216 in men with history of prostate cancer, 212 213 Puberty, testosterone and prostate growth in, 204 S Saturation model, of prostate cancer development, 210 211 Screening, for androgen deficiency, patient selection for, 168 170 Secondary hypogonadism, prevalence of, 165 167 acquired, 167 Selective estrogen receptor modulators (SERMs), to raise endogenous Semen analysis, for assessment of male fertility, 173 Sexual development, in males, 155 Sexual dysfunction, in men with obstructive sleep apnea, 235 Sexual function, effects of testosterone supplementation on, 217 222
277 phosphodiesterase type 5 inhibitors, 220 Sleep apnea. See Obstructive sleep apnea. Solutions, testosterone, 187 Spermatogenesis, preservation of, with testosterone therapy, 198 199 recovery of, with testosterone therapy, 199 200 Subcutaneous pellets, of testosterone, 189 Supplementation, testosterone. See Testosterone therapies. T Testicular function, abnormalities in, 152 153 FSH and LH and, 152 153 Testosterone, peripheral metabolism of, 153 155 serum, assays of, 177 184 Testosterone deficiency, and the prostate, 203 208 embryology of the prostate, 203 204 testosterone and prostate cancer, 206 testosterone and prostate growth, 204 obstructive sleep apnea and, 233 237 effects on testosterone level, 235 role of fatigue, Testosterone therapies, 185 193, 198 200 adverse events with, 190 191 alternatives to, 190 contraindications, 186 effect on obstructive sleep apnea, effect on sexual function, 217 222 V phosphodiesterase type 5 inhibitors, 220 follow-up and monitoring, 191 history, 185 186 lifestyle interventions to raise endogenous preservation, of spermatogenesis with, 198 199 pretreatment considerations, 186 prostate cancer and, 209 216 in men with history of prostate cancer, 212 213 recovery of spermatogenesis with, 199 200 treatment options, 186 190 buccal formulations, 187 gels and solutions, 187 long-acting injections, 189 oral preparations, 189 patches, 189 190 short-acting injections, 189 subcutaneous pellets, 189 trends in prescription of, 261 271 Varicocele, effects on testosterone, 223 232 clinical data, 223 226 pathophysiology of Leydig cell dysfunction, animal studies, 228 human studies, 226 227 varicocelectomy for hypogonadism, 228 229 Varicocelectomy, for hypogonadism, 228 229