Clinical Uses of Androgens

Question 1

how is T given? why?

Answer 1

usually transdermally or trans-buccally, due to a high level of first pass metabolism for any that is injected or swallowed

Question 2

what are the formulations for T?

Answer 2

buccal suppository - striant
gel - testim, androgel
patch - androderm,, testoderm

Question 3

what are the 17alpha-alkyl derivatives of T? what is their advantage and disadvantage?

Answer 3

methyltestosterone (specifically testred) and fluoxymestrone
Advantages: PO, longer half-life and activity
Disadvantages: serious liver toxicity
fluoxymestrone only: poor substrate for aromatase, therefore it has few estrogen derived side effects

Question 4

what are the testosterone esters? what are their advantages and disadvantages?

Answer 4

delatestryl and depotestosterone

advantage: deep IM injection, depot, cheap
disadvantage: large side effect profile, possibly because levels are supraphysiologic at time of injection