androgens

what testosterone can be used for

male hypogonadism with confirmed testosterone deficiency

delayed puberty

alleviating menopausal symptoms when combined with estrogen

treating refractory anemias (aplastic anemia, fanconi anemia)

gender affirming hormone therapy for transgender men

effects of testosterone in males pubertal transformation

increase testosterone promotes puberty in males (testes enlarge; scrotum and penis enlarge; growth of pubic and axillary hair and on trunk, arms, legs]

it also stimulates growth of bone and skeletal muscle- height and weight increase

accelerates epiphyseal closure= bone growth to stop within a few years

larynx enlarges- deepening of the voice

acne growth due to sebaceous glands increase

beard growth

testosterone effects in men spermatogenesis

androgen are needed to make sperm

testosterone in women when normal helps with

promotion of clitoral growth

maintenance of libidow

what happens when theres too much androgen in girls?

can be due to adrenal hyperplasia

virilization happens

testosterone can help with what growth of muscle

skeletal muscle

testosterone can also promote what in the bone marrow

promote synthesis of erythropoietin- producing more erythrocytes

testosterone breakdown

USE: male hypogonadism [testes fail to make testosterone], replacement therapy [testicular failure in adult males; helps with libido, increase ejaculation volume supports secondary features], delayed puberty, testosterone therapy in menopausal women [helps with reduced libido and genital sensitivity], anemias, for transgender men

AE: virilization in women, girls and boys; premature epiphyseal closure; lower HDL and elevate LDL; prostate cancer (promotes rather than cause it after it occurs); edema (retention of water and salt) ; abuse potential; risk for thromboembolic events; rash from patches

PK: oral (testosterone Undecanoate); transdermal testosterone: patch [Androderm; applied once daily at upper arm, thigh, back or abdomen; more for male hypogonadism, gel [AndroGel] give in AM on shoulder, upper arm, abdomen; topical: underarm application (Axiron) similar to gel; nasal gel: Natesto; implantable testosterone pellets; IM testosterone esters

CI: breastfeeding patients (can pass into the breast milk); children (can cause virlization & accelerate the epiphyseal closure =decrease in adult height); pregnancy (vaginal malformation, clitoral enlargement and formation of structure like male scrotum); caution with OA since it can cause thromboembolic events; CI in ages 65>; prostate cancer; breast cancer caution with heart failure

L: hematocrit; serum testosterone; lipids; liver function; PSA

black box warning for testosterone

secondary exposure to testosterone gel on uncovered skin and to testosterone gel on unwashed clothing has resulted in virilization in children

what occurs in virilization

deepening of the voice

chest and facila hair

menstrual irregularities atientp

patient education: topical testosterone

minimize skin to skin transfer

wash hands after every application

cover application site with clothing after the gel has dried

wash the application site before anticipated contact with another person

Women and children avoid contact with the users skin where testosterone was applied and wash contaminated skin if accidental contact with an application site happens

patient education: androgen

educate about viritilization and report s/s

increases in abc increase risk of thrombosis

swelling of extremities and unusual weight gain may be due to salt and water retention

child bearing age- can cause fetal malformations- use contraception

wash hands after every application and cover application site with clothing