Sex Hormones; Hypogonadism
Select one of the prompts below to complete this discussion question:
1. Select a prescription or nonprescription medication and explain the cultural and genetic factors that need to be considered when recommending or prescribing for contraception or hormone replacement. Share the mechanism of action of this medication and hints for monitoring, side effects, and drug interactions, including interactions with CAM. Include the name of the medication in the subject line so that the medications can be followed. Include references using APA format.
2. Hypogonadism affects many men and is known to be one of the main causes of infertility. Explain the pathophysiology of infertility. Discuss testosterone replacement therapy (TRT), including the benefits, risks, contraindications, potential drug interactions, preparations, and dosing. Explain the cultural and genetic factors that need to be considered when recommending or prescribing TRT. Discuss evidence and treatment guidelines to determine appropriate therapeutic options for a patient with infertility. Use evidence-based, peer-reviewed research to support your answer. Include references using APA format.
Sex Hormones; Hypogonadism
Topic 7 DQ 2
Course Code and Name
Topic 7 DQ 2
Hypogonadism is a condition characterized by the failure of gonads to produce little to no sex hormones. Pathophysiology of infertility: Infertility in men resulting from hypogonadism is due to the production of low testosterone levels that are insufficient to produce sperm. Low sperm levels also fail to inhibit the production of follicle-stimulating and luteinizing hormones. Testosterone is a male sex hormone required for sperm production (Hirsch, 2021). Testosterone replacement therapy (TRT): The therapy aims to improve symptoms of testosterone deficiency by replacing testosterone levels. Benefits are improved sexual function, increased sperm count and volume, and increased other hormones that interact with testosterone (Jewell, 2019). Risks: Stimulate the growth of prostate and breast cancer, increase symptoms of an enlarged prostate, cause gynecomastia, erythrocytosis, skin diseases, and sleep apnea.
Contraindications: TRT is contraindicated in patients with breast and prostate cancer, erythrocytosis, untreated sleep apnea, heart failure, and severe lower urinary tract symptoms (Barbonetti et al., 2020). Drug interactions: TRT interacts with a hundred and fifty-eight drugs, but of major importance are Warfarin, levothyroxine, dicumarol, mipomersen, pexidartinib, anisindione, leflunomide, teriflunomide, pazopanib, and berotralstat. Preparations and dosage: Oral lozenges 30mg twice daily, 4-6 units of implants that deliver 75mg daily, sprays of 5.5mg in each nostril thrice a day, intramuscular injections 60mg daily, 5-10g of topical cream that delivers 5-10mg testosterone daily, and transdermal patches that deliver 4mg daily (Barbonetti et al., 2020)(Hirsch, 2021). The dosage depends on individual testosterone levels. On average, patients take from 80 to 200 mg of testosterone weekly, depending on their needs, while some are in the 0.5-0.7 ml range. Monitoring: Measuring testosterone levels and lipid profiles, taking complete blood count to measure red blood cells, testing liver functions, and antigen testing specific to the prostate (Hirsch, 2021). All these tests require laboratory examinations.
Cultural and genetic factors: Males above 50 who start noticing the effects of decreasing testosterone levels are the eligible candidates. Only males with definite hypogonadism results receive TRT treatment (Leslie et al., 2022). Appropriate therapeutic options for male infertility: Therapeutic options address the causes of infertility, including lifestyle changes, surgical interventions, dopamine agonists, varicocelectomy, TRT, and IVF.
Barbonetti, A., D’Andrea, S., & Francavilla, S. (2020). Testosterone replacement therapy. Andrology, 8(6), 1551-1566. https://doi.org/10.1111/andr.12774
Hirsch, I. H. (2021, March 3). Male Hypogonadism – Genitourinary disorders – MSD manual professional edition. MSD Manual Professional Edition. https://www.msdmanuals.com/professional/genitourinary-disorders/male-reproductive-endocrinology-and-related-disorders/male-hypogonadism
Jewell, T. (2019, January 28). TRT: Uses, side effects, and cost of testosterone replacement therapy. Healthline. https://www.healthline.com/health/trt#non-medical-use
Leslie, S. W., Siref, L. E., Soon-Sutton, T. L., & B Khan, M. A. (2022, February 14). Male infertility – StatPearls – NCBI bookshelf. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK562258/