Page 161 - Urological Health

An overview of the steps to the diagnosis of testosterone deficiency is illustrated in Figure 2.

Screening Questionnaire (ADAM)

(+)

History, Physical Examination

(+)

Basic Hormonal Evaluation: Early MorningTotalTeststerone

Normal Borderline (with significant symptoms) Low

Periodic re-evaluation r/o Comprehensive Hormonal Confirm Diagnosis with
UNDER REVIEW
depression & other causes Evaluation: Comprehensive Hormonal
Evaluation:
of symptoms RepeatTestosterone, Testosterone,
LH, FSH, prolactin
LH, FSH, prolactin
OfficialTestosterone
ReplacementTherapy
Low
Normal

Figure 2. Summary of the Evaluation for Testosterone Deficiency.

Table 2. Clinical disorders or conditions associated
with a high prevalence of low testosterone levels

• Type II diabetes mellitus
• Metabolic syndrome
• Human immunodeficiency virus (HIV)
• Treatment with opioids (pain killers), glucocorticoids or ketoconazole
• Osteoporosis (weak bone structure)
• Severe kidney disease
• Chronic obstructive pulmonary disease (lung disease)
• Infertility
• Brain tumours/masses, radiation or trauma
• Use of street drugs
• Liver disease

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