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Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. - PubMed - NCBI
> We recommend T therapy for men with symptomatic T deficiency to induce and maintain secondary sex characteristics and correct symptoms of hypogonadism after discussing the potential benefits and risks of therapy and of monitoring therapy and involving the patient in decision making. We recommend against starting T therapy in patients who are planning fertility in the near term or have any of the following conditions: breast or prostate cancer, a palpable prostate nodule or induration, prostate-specific antigen level > 4 ng/mL, prostate-specific antigen > 3 ng/mL in men at increased risk of prostate cancer (e.g., African Americans and men with a first-degree relative with diagnosed prostate cancer) without further urological evaluation, elevated hematocrit, untreated severe obstructive sleep apnea, severe lower urinary tract symptoms, uncontrolled heart failure, myocardial infarction or stroke within the last 6 months, or thrombophilia. We suggest that when clinicians institute T therapy, they aim at achieving T concentrations in the mid-normal range during treatment with any of the approved formulations
testosterone  endocrinology  hypogonadism  prostate 
june 2018 by porejide
Oxybutynin for Hot Flashes Due to Androgen Deprivation in Men | NEJM
> After 2 weeks, he had abrupt onset of nightly drenching hot flashes that occurred every 20 to 30 minutes beginning at 2:30 a.m. The hot flashes were bothersome and intrusive and prevented sleep. The addition of extended-release venlafaxine (75 mg) did not help, nor did increasing the dose of gabapentin to 900 mg at night and 1500 mg a day in total. After more than 21 days of treatment with combined venlafaxine–gabapentin without benefit, oxybutynin (5 mg twice a day) provided relief from the sweating within 2 hours and allowed the patient to sleep through the night. He continued taking the oxybutynin (1.25 to 2.5 mg twice a day) for 40 days and had only transient hourly body warmth, which was far less intrusive than the hot flashes. He tapered and stopped the gabapentin and venlafaxine without a change in the control of his hot flashes. When he stopped taking oxybutynin because of insomnia, dry mouth, and the restless legs syndrome, the hot flashes returned; he restarted treatment with oxybutynin at 2.5 mg twice a day, and relief occurred within hours. The insomnia was managed with intermittent zolpidem treatment.
hot_flashes  menopause  gender  prostate  oxybutynin 
may 2018 by porejide

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