On-Demand | Difficult cases of Testosterone Replacement in Male Hypogonadism-Video-Difficult cases of Testosterone Replacement in Male Hypogonadism

Video Transcription

Video Summary

In his talk, George Tso discusses the challenges and recent updates in testosterone replacement therapy (TRT) for hypogonadism. The presentation covers normal testosterone levels, the effects of TRT on symptoms like fatigue and sexual dysfunction, and its safety, especially in patients with risk factors such as venous thromboembolism, prostate cancer, and cardiovascular disease.<br /><br />Tso explains that testosterone levels generally decrease gradually from adulthood into old age but notes significant individual variability due to health and lifestyle factors like obesity and smoking. He emphasizes diagnosing low testosterone accurately, highlighting that not all symptoms like erectile dysfunction and fatigue are solely due to low testosterone. Tso addresses the challenges in diagnosing late-onset hypogonadism and emphasizes the need for correct assessment, as low testosterone can be indicative of underlying health issues rather than a direct cause of symptoms.<br /><br />He elaborates on research demonstrating TRT's limited effects on erectile dysfunction but notes improvements in libido and overall sexual activity. He also discusses fatigue, noting that TRT shows inconsistent benefits. Tso cautions about the potential side effects of TRT, including increased PSA levels and venous thromboembolism risks, and discusses data suggesting TRT may be safe for the heart, though the evidence is nuanced.<br /><br />The talk concludes with the importance of selecting the right patients for TRT, considering individual health profiles and risks, to ensure the therapy's benefits outweigh potential harms. Tso underscores the medical principle of "do no harm" and urges careful patient evaluation in TRT administration.

Keywords

testosterone replacement therapy

hypogonadism

testosterone levels

fatigue

sexual dysfunction

venous thromboembolism

prostate cancer

cardiovascular disease

late-onset hypogonadism

patient evaluation


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