Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C1519176 (PSA)
 5,490 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Androgen deficiency is diagnosed by ascertainment of characteristic signs and symptoms and consistently low testosterone levels, measured preferably in the morning using a reliable assay. The clinical presentation of androgen deficiency varies with the age of its onset, genetic factors, prior treatment, and other host factors. Androgen deficiency can be treated using any one of the approved testosterone formulations after consideration of pharmacokinetics, patient preference, cost, and potential formulation-specific adverse effects. Prostate and breast cancer, erythrocytosis, untreated severe obstructive sleep apnea, congestive heart failure, recent myocardial infarction, and severe lower urinary tract symptoms are contraindications for testosterone therapy. Testosterone therapy should be accompanied by a standardized monitoring plan that includes periodic ascertainment of symptomatic improvement and lower urinary tract symptoms, measurements of testosterone level, hematocrit, and PSA, digital prostate examination, and general health evaluation. While the benefit to risk ratio is generally favorable in healthy young men with classical hypogonadism due to diseases of the testes, pituitary and the hypothalamus, neither the clinical benefits of testosterone therapy on patient-important outcomes nor its long-term risks in older men with age-related decline in testosterone level are known.
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PMID:Diagnosis and treatment of hypogonadism in men. 2139 97

The T Trials were a coordinated set of seven double-blind, placebo-controlled trials to assess efficacy and safety of testosterone versus placebo gel treatment for one year in 788 older men 65 years or older with hypogonadism who had self-reported and objective impairment of sexual and physical function and/or vitality and an average of two morning serum testosterone concentrations < 275 ng/dL. Testosterone dose was adjusted to the mid-normal range for young men. Compared to placebo, testosterone treatment moderately improved sexual function, hemoglobin concentration and corrected anemia, and slightly improved walking distance, vitality, mood and depressive symptoms and bone density and strength, but did not improve cognitive function. Testosterone treatment slightly increased non-calcified and total plaque volume; while concerning, the clinical significance of this finding is not clear. Testosterone treatment also increased PSA levels and referral for urological evaluation, and caused erythrocytosis in some men. The T Trials provided definitive evidence for short-term clinically meaningful, albeit modest benefits and risks of testosterone treatment in older men with unequivocal age-related hypogonadism. Larger and longer-term placebo-controlled clinical trials are needed to assess the long-term benefits and risks of testosterone treatment on clinical outcomes such as frailty, depression, fractures, prostate cancer and cardiovascular events.
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PMID:Testosterone Replacement in Men with Age-Related Low Testosterone: What Did We Learn From The Testosterone Trials? 3204 15