Androgens in Health and Disease.pdf - E Library

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319 Androderm ® (permeation- 5–7.5 mg every PM $120/mo (5 mg/d) Physiological T levels, Frequent skin irritation, enhanced, reservoir, circadian variation occasionally severe nonscrotal patch) No injections (↓ by coapplication of Good adhesion corticosteroid cream) Normal DHT levels More expensive than Testoderm Higher dose requires 2 patches Limited dose flexibility Testoderm TTS ® (non- 5–10 mg every AM $110/mo (5 mg/d) Physiological T levels, Poor adhesion to skin permeation-enhanc circadian variation More expensive than Androderm reservoir, nonscrotal patch) No injections Larger patch than others Less skin irritation than Higher dose requires 2 patches Androderm Limited dose flexibility Transdermal T gel AndroGel ® T in 50–100 mg every AM $165/mo (50 mg/d) Steady-state T levels Potential transfer of T to women hydroalcholic gel and children by contact (prevented by clothing and washing after 2 h) No injections Little skin irritation Subcutaneous T pellets Tesopel® Pellets 225–450 mg (3–6 pellets) $30/mo Long-term, steady-state Minor surgical procedure implanted sc every 3–4 mo (450 mg/3 mo) T levels Extrusion, bleeding, and infection, although uncommon Pellets not easily removable Very seldom used a Approximate average wholesale price (AWP) from 2001 Drug Topics Redbook, Medical Economics Thomson Health Care, Montvale, NJ, 2001. Note: DHT = dehydrotestosterone. Chapter 16/Androgen Treatment of the Hypogonadal Male 319
320 Matsumoto Fig. 1. Mean serum T concentrations during T-replacement therapy in hypogonadal men. (A) Serum T levels after the last injection of 100 mg T enanthate im every week (triangles) or 200 mg im every 2 wk (circles), at the end of 12 wk of treatment. Arrows represent the times of T enanthate injections, and dashed lines represent the normal range for T (adapted from ref. 22). (B) Serum T levels before and after applications of T gel (AndroGel) 5 g (50 mg of T, squares) or 10 g (100 mg of T, circles) daily, or a T patch (Androderm) 5 mg (triangles) daily, after 90 d of treatment. Arrows represent the times of transdermal T application (time 0 was 0800 h), and dashed lines represent the normal range for T (adapted from ref. 23). therapy may be quite distressing both to the patients and their sexual partners. Counseling of hypogonadal men and their partners prior to and during T treatment plays an important role in reducing the likelihood of serious adjustment problems associated with androgen therapy. In some men, initiating therapy with a low dosage of T (e.g., 100 mg T enanthate or T cypionate every 2 wk) for several months, followed by a gradual escalation to a full androgen-replacement dosage may be the most prudent approach. In some clinical situations, a full androgen-replacement dosage may not be necessary (e.g., elderly men with severe prostate disease in whom the anabolic actions of T on muscle and bone are the primary therapeutic goals). In these instances, low-dose T
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CONTEMPORARY ENDOCRINOLOGY Androgen
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CONTEMPORARY ENDOCRINOLOGY P. Micha
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© 2003 Humana Press Inc. 999 River
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vi Preface We hope Androgens in Hea
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viii Contents 13 Androgens and Body
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x Contributors RICHARD S. LEGRO, MD
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2 Winters and Clark
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4 Winters and Clark chorionic gonad
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6 Winters and Clark LH REGULATION O
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8 Winters and Clark These enzymes a
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10 Winters and Clark -subunit mRNA
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12 Winters and Clark Fig. 3. A sche
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14 Winters and Clark Table 1 Factor
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16 Winters and Clark Table 2 Tissue
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18 Winters and Clark 11. Thomas JL,
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20 Winters and Clark 61. Dufau ML,
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22 Winters and Clark 112. Raivio T,
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24 Brown Fig. 1. Mechanism for andr
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26 Brown increase in intracellular
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28 Brown Fig. 2. Structural and fun
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30 Brown Fig. 3. Amino acid sequenc
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32 Brown tions to shuttle the AR th
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34 Brown Fig. 4. Amino acid primary
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36 Brown part of an inactive chroma
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38 Brown the external genitalia is
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40 Brown tors, as well as the trans
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42 Brown 49. Williams SP, Sigler PB
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44 Brown 100. Gregory CW, He B, Joh
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46 Plymate Table 1 Classification o
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48 Plymate In addition to the direc
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50 Plymate LABORATORY FINDINGS In p
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52 Plymate those manifesting as phe
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54 Plymate result in some improveme
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56 Plymate If both testosterone and
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58 Plymate Persistent Müllerian Du
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60 Plymate INFERTILITY RESULTING FR
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62 Plymate unaffected, contralatera
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64 Plymate SECONDARY HYPOGONADISM H
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66 Plymate Other syndromes manifest
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68 Plymate period after the burn. I
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70 Plymate These findings suggest t
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72 Plymate 49. Goebelsmann U, Horto
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74 Plymate 104. Yoshimoto Y, Moride
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76 Plymate
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78 Sutton, Amory, and Clark levels
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80 Sutton, Amory, and Clark cebo in
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82 Sutton, Amory, and Clark Finaste
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84 Sutton, Amory, and Clark through
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86 Sutton, Amory, and Clark 40. The
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88 Sutton, Amory, and Clark 88. Rob
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90 Lindzey and Korach Fig. 1. Cellu
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92 Lindzey and Korach estrogen sign
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94 Lindzey and Korach TESTIS AND DU
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96 Lindzey and Korach sufficient to
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98 Lindzey and Korach Seminal Vesic
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100 Lindzey and Korach 17. Krege JH
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102 Lindzey and Korach 68. Chang WY
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104 McPhaul on the Y chromosome det
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106 106 McPhaul
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108 McPhaul number of alleles, dele
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110 McPhaul The first mutation of t
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112 McPhaul gene. In vitro studies
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114 McPhaul risk of impaired sperma
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116 McPhaul carrying a single mutan
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118 McPhaul REFERENCES 1. Koopman P
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120 McPhaul 45. Weidemann W, Peters
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122 McPhaul 92. Koivisto P, Kononen
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124 Legro Fig. 1. The spectrum of p
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126 Legro Virilization presents wit
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128 Legro Fig. 3. The paradox of an
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130 Legro small high-density athero
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132 Legro Table 2 Syndromes or Dise
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134 Legro Insulin-Sensitizing Agent
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136 Legro is undetermined according
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138 Legro 39. Lee O, Farquhar C, To
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140 Legro
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142 Wang and Swerdloff PHARMACOLOGY
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144 Wang and Swerdloff The 17α-alk
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146 Wang and Swerdloff Table 2 Dose
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148 Wang and Swerdloff The steroid
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150 Wang and Swerdloff The inabilit
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152 Wang and Swerdloff 15. De Lorim
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154 Wang and Swerdloff
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156 Marcelli et al.
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158 Marcelli et al. Differentiated
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160 Marcelli et al. These coactivat
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162 Marcelli et al. tigators have e
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164 Marcelli et al. AR in Prostate
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166 Marcelli et al. Table 1 Androge
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168 Marcelli et al. A molecular exp
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170 Marcelli et al. The above data
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172 Marcelli et al. up to 9 yr late
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174 Marcelli et al. Three major pha
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176 Marcelli et al. vitro model of
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178 Marcelli et al. yr, survival wa
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180 Marcelli et al. 26. McKenna NJ,
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182 Marcelli et al. 78. Isaacs J, C
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184 Marcelli et al. 126. Watanabe M
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186 Marcelli et al. 177. Kousteni S
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188 Marcelli et al. 231. Colombel M
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190 Marcelli et al.
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192 Wu and von Eckardstein contrace
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194 Wu and von Eckardstein beam com
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196 Wu and von Eckardstein excess o
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198 Wu and von Eckardstein Endogeno
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Table 3 Change in Lipids in Hypogon
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Table 3 (continued) ∆LDL ∆HDL
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204 Wu and von Eckardstein THE HEMO
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206 Wu and von Eckardstein In vivo
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208 Wu and von Eckardstein (uptake
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210 Wu and von Eckardstein 4. Bhasi
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212 Wu and von Eckardstein 57. Barr
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214 Wu and von Eckardstein 107. Fra
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216 Wu and von Eckardstein 152. Zmu
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218 Wu and von Eckardstein 201. Cho
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220 Wu and von Eckardstein 250. Eic
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222 Kenny and Raisz with a cartilag
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224 Kenny and Raisz METABOLISM OF A
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226 Kenny and Raisz The level of th
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228 Kenny and Raisz REFERENCES 1. G
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230 Kenny and Raisz 51. Morishima A
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232 Kenny and Raisz 103. Snyder PJ,
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234 Basaria and Dobs losses in wome
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236 Basaria and Dobs 15 dialysis pa
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238 Basaria and Dobs duced remissio
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240 Basaria and Dobs hematocrit lev
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242 Basaria and Dobs 40. Sanchez-Me
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244 Katznelson in men with testoste
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246 Katznelson Fig. 1. Body weight,
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248 Katznelson change during treatm
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250 Katznelson testosterone or free
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252 Katznelson disproportionate dec
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254 Katznelson have been additional
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256 Katznelson 18. Marin P, Lonn L,
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258 Katznelson 71. Davis SR, McClou
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260 Bancroft Androgen Deficiency an
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262 Bancroft studies had presented
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264 Bancroft Bagatell et al. (36) g
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266 Bancroft much larger group of a
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Page 283 and 284: 272 Bancroft Particularly confusing
Page 285 and 286: 274 Bancroft 4. Studies using place
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Page 289 and 290: 278 Bancroft cytotoxic therapy supp
Page 291 and 292: 280 Bancroft Women with Endocrine A
Page 293 and 294: 282 Bancroft in response to the fil
Page 295 and 296: 284 Bancroft Men are much more awar
Page 297 and 298: 286 Bancroft 22. Morales A, Johnsto
Page 299 and 300: 288 Bancroft 78. Hyde JS, DeLamater
Page 301 and 302: 290 Bancroft 129. Appelt H, Strauss
Page 303 and 304: 292 Cherrier and Craft Fig. 1. Path
Page 305 and 306: 294 Cherrier and Craft ment of the
Page 307 and 308: 296 Cherrier and Craft information
Page 309 and 310: 298 Cherrier and Craft Fig. 3. Wech
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Page 313 and 314: 302 Cherrier and Craft occurring wi
Page 315 and 316: 304 Cherrier and Craft gesting that
Page 317 and 318: 306 Cherrier and Craft 39. Gouchie
Page 319 and 320: 308 Cherrier and Craft 94. Kelso WM
Page 321 and 322: 310 Cherrier and Craft
Page 323 and 324: 312 Matsumoto
Page 325 and 326: 314 Matsumoto long-term benefits an
Page 327 and 328: 316 Matsumoto manifestations (7). F
Page 329: 318 Formulation Usual adult dosage
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Page 339 and 340: 328 Matsumoto such as hepatic cirrh
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Page 345 and 346: 334 Matsumoto 77. Dobs AS, Meikle A
Page 347 and 348: 336 Richmond and Rogol PHYSIOLOGY O
Page 349 and 350: 338 Richmond and Rogol activity (28
Page 351 and 352: 340 Richmond and Rogol increase lin
Page 353 and 354: 342 Richmond and Rogol curve, the h
Page 355 and 356: 344 Richmond and Rogol Permanent hy
Page 357 and 358: 346 Richmond and Rogol 46. Stanhope
Page 359 and 360: 348 Tenover In aging men, the combi
Page 361 and 362: 350 Tenover Table 1 Changes in Andr
Page 363 and 364: 352 Tenover studies in which eugona
Page 365 and 366: 354 Tenover Table 3 Testosterone Th
Page 367 and 368: 356 Tenover Table 5 ART in Older Me
Page 369 and 370: 358 Tenover be overcome with either
Page 371 and 372: 360 Tenover Laboratory tests should
Page 373 and 374: 362 Tenover 40. Kohrt WM, Malley MT
Page 375 and 376: 364 Tenover 95. Mooradian AD, Morle
Page 377 and 378: 366 Davis Table 1 Proposed Androgen
Page 379 and 380: 368 Davis transdermal testosterone
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370 Davis increase in circulating t
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372 Davis (93). Most recently, Zhou
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374 Davis Table 4 Androgen Replacem
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376 Davis 8. Vierhapper H, Nowotny
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378 Davis 60. Simberg N, Titinen A,
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380 Davis
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382 Bhasin, Woodhouse, and Storer h
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384 Table 2 Effects of Testosterone
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386 Bhasin, Woodhouse, and Storer e
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388 Bhasin, Woodhouse, and Storer F
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390 Bhasin, Woodhouse, and Storer t
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Table 3 Effects of Testosterone Sup
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Table 4 Effects of Testosterone Sup
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396 Bhasin, Woodhouse, and Storer c
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398 Bhasin, Woodhouse, and Storer C
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400 Bhasin, Woodhouse, and Storer w
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402 Bhasin, Woodhouse, and Storer 4
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404 Bhasin, Woodhouse, and Storer
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406 Amory Fig. 1. The endocrinology
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408 Amory pregnancies fathered by t
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410 Amory antagonists can suppress
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412 Amory 100-mg doses of weekly TE
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414 Amory FUTURE DIRECTIONS Given t
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416 Amory 22. Oral contraception. I
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418 Amory
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420 Anawalt inadequate androgen eff
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422 Anawalt few specialty commercia
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424 Anawalt Fig. 1. (C) Secondary h
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426 Anawalt Fig. 2. Evaluation and
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428 Anawalt All men with secondary
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430 Anawalt anemia (38). With the a
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432 Anawalt osterone levels achieve
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434 Anawalt SIDE EFFECTS OF ANDROGE
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436 Anawalt 7. Rosner W. Errors in
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438 Anawalt 59. Mackey MA, Conway A
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440 Index polycystic ovaries, 131 A
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442 Index lipoid congenital adrenal
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444 Index women, 254 dihydrotestost
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446 Index Pituitary adenoma, male h
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448 Index lipoid congenital adrenal
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