Secondary ED

Question 1

What are the lab test for secondary ED?

Answer 1

Serum Testosterone: 2 serial early morning samples required

Serum prolactin:elevated levels cause-decrease levels of sex hormones

Fasting blood glucose and lipid profile

Question 2

What must you remember when diagnosing ED ? ?

Answer 2

must rule out low-T or a pituitary disorder, cause PDE5 may work but underlying cause is not addressed

Question 3

Whats the FDA excerpt on testosterone?

Answer 3

Testosterone is only approve for low levels in conjunctions with a medical condtion

Question 4

what is hypoganadism?

Answer 4

Sex glands produce low or no hormones

decrese libido and cause secondary ED

Question 5

When is testoerone the highest?

Answer 5

In the morning.

low in evening

Question 6

what is is testosterone converted to?

Answer 6

DHT

50x more potent

Stimulated growth, hair growth, and induces baldness and causes acne.

Question 7

PO testosterone product?

Answer 7

Fluxymesterone (Androxy)

methlytestosterone (Android, methtest, testred)

Question 8

IM testoterone?

Answer 8

Testosterone cypionate (Depo-testostorne)
Testosterone enathate (Delatestyl)

Question 9

Transdermal testosterone

Answer 9

Androderm

Question 10

Transdermal Gel/soulution testosterione?

Answer 10

Androgel,Fortesta,Testim,Axiron

Question 11

Pellet testosterone?

Answer 11

Testopel

Question 12

Buccal testosterone?

Answer 12

Striant

Question 13

What are the details of Striant (buccul)

Answer 13

30 mg q12hrs
do no swallow or chew

not affected by food,toothbrushing, gum or alcohol

monitor after 4 to 12 weeks in the morning before the dose

Pros: less fluctuations
Cons:mouth irration

Question 14

What are the details of Testopel (pellet)

Answer 14

150-140mg SQ q3-6months

Pros:long acting
cons: inflamation and pain difficult to adjust dose

• *absorbed in decresing fraction over time
• *monitor levels at end of dosing interval

Question 15

Whats the details of Gel and solutions?

Answer 15

pros: less skin irruption and fluctuations of T levels
cons: addicental transfer to other

• *monitor weekly
• *do not apply patch to genitals

Question 16

Gel and solutions: Special instructions?

Apply once daily

Answer 16

Androgel - reduce fluctuations if applied to abs

Testim do no apply to abdomen

Axiron - apply deodorant before the gel

Fortsta : none

Question 17

Whats the details of Androderm?

Answer 17

Pro: convient, mimmic diumal levels
cons:skin reaction (35%)

Do not apply to scrotum
treat skin rxn with low potency steroid cream
monitor T-levels 3-12 hours after application

2 or 4mg/day at night

Question 18

Whats the details of IM testosterone?

Testosterone cypionate (Depo-testostorne)40-1400 IM q2-4weeks

Testosterone enathate (Delatestyl) 400mg/month

Answer 18

Pro: cheap
con:fluctuations of T-levels, pain at injection site, cough (rare),excessive erythrocytosis,

• *effect wane after 2-3 weeks–>recommend Q1-2weeks
• *monitor–check T-level a midpoint b/t injections

Question 19

What the deal with PO testosterone? CIII

Fluxymesterone (Androxy)
methlytestosterone (Android, methtest, testred) 10-15mg daily

Answer 19

Pro:easy and flexible dosing, immediate DC
Cons:Variale resonse, adverse lipid chagnes

**not reccomened for androgen defienciecy due to potential–Hepatotoxicy **