A digital rectal examination and a serum prostate-specific antigen (PSA) test should be performed by the physician to assess prostate abnormalities before a middle-aged or older patient is started on androgen treatment. If the serum PSA is elevated or nodules or irregularities are found, the patient should be referred for urological assessment. A complete blood count, liver function tests, and a lipid panel should be performed to ensure that the subject does not have an elevated hemoglobin or hematocrit, and to assess the baseline liver enzymes and serum total, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol.
Table 1 Androgen Therapy
• Improves sexual function
• Maintains secondary sex characters
• T Bone mass, muscle mass, and strength
• Improves mood in hypogonadal men
• Cognitive function?
• Coronary vasodilation?
• Gynecomastia, decreased testis volume, and suppressed spermatogenesis
• Weight gain, fluid retention
• Prostate dysfunction (CAP, BPH)
• T Hematocrit/hemoglobin
HDL, high-density lipoprotein; LDL, low-density lipoprotein; CAP, carcinoma of the prostate; BPH, benign prostate hyperplasia.
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