Diagnostic Protocols and Alternative Treatment Options for Male Hypogonadism
Presented at the 13th Clinical Applications for Age Management Medicine, November 2012, Las Vegas, NV Rethinking the Hypothalamic-Pituitary-Gonadal Axis Underlying Mechanisms, Novel Diagnostic Protocols and Alternative Treatment Options for Male Hypogonadism Karlis C. Ullis, MD Private Practice, Sports Medicine and Preventive Medicine Group, Santa Monica, CA Alan Gurler, MS Personal Fitness Trainer, AG Fitness, West Los Angeles, CA Lecture Description: Classic clinical age management practice has primarily focused on long-term testosterone replacement therapy (TRT) for optimal aging. It has become increasingly apparent that the age of hypogonadism is occurring at younger ages and symptoms (eg Low Testosterone Syndromes) may be present despite specific T serum values being within so-called normal laboratory reference ranges. There is a gradient of maleness and androgenicity which has recently been elucidated. The maleness gradient is associated with androgen receptor sensitivity differences in men. This gradient may explain long-term effects of androgens throughout a male's lifetime. Many middle-aged or younger men no longer want sole treatment with long-term TRT for low testosterone values and/or symptoms. Because of the increasing prevalence of TRT it is important to revisit the misconception that only supraphysiologic doses of testosterone have the capacity to suppress endogenous testosterone production, spermatogenesis and other normal male physiological processes. We ...
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