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Androgen Replacement Therapy

The use of hormones is included in the treatment of menopause and andropause symptoms, growth hormone deficiency, diabetes, hypothyroidism, and sex reassignment therapy. While HRT is generally thought of as a remedy for menopause in older women, it can be prescribed to males with age-related hormonal issues. More specifically, androgen replacement therapy (ART) has proven to be effective for men with testosterone deficiency syndrome. According to Barbosa and Cury (2018), more than a third of the male population over 45 years old may experience andropause. However, Park et al. (2019) argue that many testosterone users do not meet the therapy requirements. Winters and Huhtaniemi (2017) note that roughly a quarter of those receiving therapy have not undergone testing for testosterone levels. Park et al. (2019) add that the number of testosterone prescriptions declined in recent years following the researches that confirmed increased chances of stroke and heart disease in testosterone users. Overall, ART remains a controversial subject as its benefits often do not outweigh the side effects.

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A 50-year old male with hypogonadism suffering from depression, loss of concentration, and sleep disturbance could be a suitable candidate for ART. According to Barbosa and Cury (2018), the presence of several symptoms and low testosterone levels can make a case for the use of ART. The studies have consistently shown the positive effect of ART on psychological and physical health aspects. However, the patient would need to consider adverse effects, such as low fertility and, arguably, higher risks of prostate cancer and cardiovascular issues.

There are three main options for ART – injections, gel, and tablets. Barbosa and Cury (2018) note that gel use bears the risk of transmission to children or partners, while tablets can cause inflammation of the gums. Intramuscular injections are considered to have the least adverse effects. Winters and Huhtaniemi (2017) cite high cardiovascular risks and breast and prostate cancers as contraindications for ART. Potential risks of the therapy include acne, decreased testis volume, gynecomastia, and weight gain (Winters & Huhtaniemi, 2017). The influence of ART on cardiovascular and cancer risks remains a controversial subject, as different studies have shown contrasting results.

References

Barbosa, J. A. B. A., & Cury, J. (2018). Androgen replacement therapy in men: current evidence and controversy. Revista de Medicina (São Paulo), 97(3), 295-300. Web.

Park, H. J., Ahn, S. T., & Moon, D. G. (2019). Evolution of guidelines for Testosterone Replacement Therapy. Journal of Clinical Medicine, 8(3), 410. Web.

Winters, S. J., & Huhtaniemi, T. I. (2017). Male hypogonadism: Basic, clinical and therapeuticp. Humana Press.

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