Endocrinology and Metabolism Clinics of North America This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Forthcoming Issues
Updates in Thyroidology (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 23, 2022 Category: Endocrinology Source Type: research

Diagnosis and Evaluation of Hypogonadism
A systematic approach to diagnose hypogonadism initially establishes the presence of symptoms/signs of testosterone deficiency, considers other potential causes of manifestations, and excludes conditions that transiently suppress testosterone. Hypogonadism is confirmed by measuring fasting serum total testosterone in the morning on at least 2 separate days, or free testosterone by equilibrium dialysis or calculated free testosterone in men with conditions that alter sex hormone –binding globulin or serum total testosterone near lower limit of normal. To guide management, further evaluation is performed to identify the sp...
Source: Endocrinology and Metabolism Clinics of North America - February 8, 2022 Category: Endocrinology Authors: Alvin M. Matsumoto Source Type: research

The Benefits and Risks of Testosterone Treatment in Older Hypogonadal Men
As men age, their serum testosterone concentrations decrease —the total testosterone very little but the free testosterone more. Testosterone treatment of older men whose serum testosterone concentrations are unequivocally low to bring their testosterone levels to normal for young men improves their sexual function, walking, mood, bone mineral density, and hemoglobin, but does not improve their sense of vitality or cognitive function. This treatment has also been suspected of increasing the risk of prostate cancer, benign prostatic hyperplasia, and heart disease, but these possible risks have neither been confirmed nor r...
Source: Endocrinology and Metabolism Clinics of North America - February 8, 2022 Category: Endocrinology Authors: Peter J. Snyder Source Type: research

Testosterone, Diabetes Risk, and Diabetes Prevention in Men
Middle-aged and older men with lower testosterone concentrations are more likely to have or to develop metabolic syndrome and type 2 diabetes. Central adiposity is a risk factor for metabolic syndrome and diabetes and predisposes to lower testosterone concentrations. Conversely, testosterone treatment reduces fat mass and insulin resistance. In a randomized controlled trial of 1007 men with either impaired glucose tolerance or newly diagnosed type 2 diabetes, 2  years of testosterone treatment on a background of lifestyle intervention reduced the risk of type 2 diabetes by 40%; this demonstrates the potential utility for ...
Source: Endocrinology and Metabolism Clinics of North America - February 8, 2022 Category: Endocrinology Authors: Bu B. Yeap, Gary A. Wittert Source Type: research

Testosterone Replacement Therapy in Hypogonadal Men
All approved testosterone replacement methods, when used according to recommendations, can restore normal serum testosterone concentrations, and relieve symptoms in most hypogonadal men. Selection of the method depends on the patient's preference with advice from the physician. Dose adjustment is possible with most delivery methods but may not be necessary in all hypogonadal men. The use of hepatotoxic androgens must be avoided. Testosterone treatment induces reversible suppression of spermatogenesis; if fertility is desired in the near future, human chronic gonadotropin, selective estrogen receptor modulator, estrogen ant...
Source: Endocrinology and Metabolism Clinics of North America - February 8, 2022 Category: Endocrinology Authors: Christina Wang, Ronald S. Swerdloff Source Type: research

Body Image Disorders and Anabolic Steroid Withdrawal Hypogonadism in Men
Hypogonadism commonly occurs during withdrawal from anabolic-androgenic steroid (AAS) use, particularly when users have been taking AAS for prolonged periods. Mounting evidence now suggests that AAS-induced hypogonadism may persist for months or even years after last AAS use, and in some cases may be partially or completely irreversible. Treatment with human chorionic gonadotropin and clomiphene may help to restore hypothalamic-pituitary-testicular axis function, and these substances are widely used illicitly by AAS users at the end of a course of AAS as so-called postcycle therapy. Many endocrinologists still have only li...
Source: Endocrinology and Metabolism Clinics of North America - February 8, 2022 Category: Endocrinology Authors: Harrison G. Pope, Gen Kanayama Source Type: research

Optimized Use of the Electronic Health Record and Other Clinical Resources to Enhance the Management of Hypogonadal Men
Electronic health records (EHRs) have enabled electronic documentation of a tremendous amount of clinical data. EHRs have the potential to improve communication between patients and their providers, facilitate quality improvement and outcomes research, and reduce medical errors. Conversely, EHRs have also increased clinician burnout, information clutter, and depersonalization of the interactions between patients and their providers. Increasing clinician input into EHR design, providing access to technical help, streamlining of workflow, and the use of custom templates that have fewer requirements for evaluation and managem...
Source: Endocrinology and Metabolism Clinics of North America - February 8, 2022 Category: Endocrinology Authors: Anna Goldman, Martin Kathrins Source Type: research

Fertility Considerations in Hypogonadal Men
Hypogonadism can be present in up to 40% in men who present with couple infertility. Testosterone is the major androgen regulating-spermatogenesis in men; as a result, men with either primary or secondary hypogonadism may be subfertile because of impaired spermatogenesis. The clinical impact of hypogonadism on fertility potential depends on the timing of its onset (fetal, prepubertal, or postpubertal) and effect on semen parameters. Treatment pathways and success rates differ according to the cause of hypogonadism and the time of its onset. When medical therapy fails to induce sufficient sperm, assisted reproductive techno...
Source: Endocrinology and Metabolism Clinics of North America - February 8, 2022 Category: Endocrinology Authors: Nikoleta Papanikolaou, Rong Luo, Channa N. Jayasena Source Type: research

Regulation of the Hypothalamic-Pituitary-Testicular Axis: Pathophysiology of Hypogonadism
Male hypogonadism is a clinical syndrome characterized by the diminished functional activity of the testis resulting in low levels of testosterone and/or spermatozoa. Defects at one or more levels of the hypothalamic-pituitary-testicular (HPT) axis can result in either primary or secondary hypogonadism. The changes that occur in the HPT axis from fetal to adult life are fundamental to understanding the pathophysiology of hypogonadism. In this article, we summarize the maturation and neuroendocrine regulation of the HPT axis and discuss the major congenital and acquired causes of male hypogonadism both at the (1) hypothalam...
Source: Endocrinology and Metabolism Clinics of North America - February 8, 2022 Category: Endocrinology Authors: Aditi Sharma, Channa N. Jayasena, Waljit S. Dhillo Source Type: research

Testosterone Treatment and the Risk of Prostate Adverse Events
Hypogonadism is a common clinical condition affecting men, with older men having an increased incidence. Clinicians (endocrinologists and urologists) who may be involved in providing testosterone therapy should be familiar with the effects of testosterone on the prostate. Before initiating testosterone therapy, physicians and patients should partake in shared decision-making, including pretreatment testing, risks and benefits of testosterone therapy relating to benign prostatic hyperplasia and lower urinary tract symptoms, a discussion on prostate cancer in those who have not been diagnosed with malignancy, and a thorough ...
Source: Endocrinology and Metabolism Clinics of North America - February 8, 2022 Category: Endocrinology Authors: Jason A. Levy, Arthur L. Burnett, Adrian S. Dobs Source Type: research

Testosterone Treatment As a Function-Promoting Therapy in Sarcopenia Associated with Aging and Chronic Disease
Sarcopenia is characterized by loss of muscle strength and physical ability because of aging and/or chronic disease. Supplemental testosterone and other androgenic-anabolic steroids have been investigated as countermeasures to ameliorate the negative consequences of sarcopenia; these trials show dose-related improvements in lean body mass, maximal voluntary strength, stair climbing power, aerobic capacity, self-reported function, and hemoglobin, but less consistent improvements in walking speed. Randomized clinical trials with large cohorts and patient-important outcome measures are needed to determine long-term efficacy a...
Source: Endocrinology and Metabolism Clinics of North America - February 8, 2022 Category: Endocrinology Authors: Marcelo Rodrigues Dos Santos, Thomas W. Storer Source Type: research

Monitoring of Testosterone Replacement Therapy to Optimize the Benefit-to-Risk Ratio
For hypogonadal men treated with testosterone, the goal is to ensure that benefits are optimized, risks are minimized, and any adverse effects are identified early and managed appropriately. This can best be achieved by careful patient selection, excluding men with contraindications and addressing any modifiable risk factors in those at increased risk. A standardized plan should be used for monitoring that includes evaluation of symptoms, side effects, adherence, and measurement of testosterone and hematocrit. Shared decision making should be used to determine whether to screen for prostate cancer and informed by age, base...
Source: Endocrinology and Metabolism Clinics of North America - February 8, 2022 Category: Endocrinology Authors: Frances J. Hayes Source Type: research

Epidemiology of Male Hypogonadism
The epidemiology of male hypogonadism has been understudied. Of the known causes of endogenous androgen deficiency, only Klinefelter syndrome is common with a likely population prevalence of greater than 5:10,000 men (possibly as high as 10 –25:10,000). Mild traumatic injury might also be a common cause of androgen deficiency (prevalence 5–10:10,000 men), but large, long-term studies must be completed to confirm this prevalence estimation that might be too high. The classic causes of male androgen deficiency—hyperprolactinemia, p ituitary macroadenoma, endogenous Cushing syndrome, and iron overload syndrome—are rar...
Source: Endocrinology and Metabolism Clinics of North America - February 8, 2022 Category: Endocrinology Authors: Arthi Thirumalai, Bradley D. Anawalt Source Type: research

Updates in Male Hypogonadism
The “Hypogonadism” issue of the Endocrinology and Metabolism Clinics of North America offers a comprehensive update on a topic that is of great interest to primary care physicians, internists, and many specialists (endocrinologists, geriatricians, urologists). We chose this topic due to developments in recent years, such as publication of clinical trials and updated practice guidelines. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 8, 2022 Category: Endocrinology Authors: Adriana G. Ioachimescu Tags: Foreword Source Type: research

Hypogonadism
This special issue of the Endocrinology and Metabolism Clinics of North America offers a compendium of articles authored by the leading experts on the epidemiology, diagnosis, and treatment of hypogonadism in men. A confluence of historical factors renders this compendium on Hypogonadism in Men timely. The growing public interest in men's health, particularly in men's sexual health, is reflected in the extraordinary increase over the past 20 years in testosterone's prescription sales in the United States and some other Western countries, combined with the opening of large numbers of men's health clinics across the United S...
Source: Endocrinology and Metabolism Clinics of North America - February 3, 2022 Category: Endocrinology Authors: Shalender Bhasin, Channa N. Jayasena Tags: Preface Source Type: research