Male Health Pharmacology: Testosterone, ED, BPH & Treatment Strategies

What are androgens?

Male sex hormones responsible for growth and development of male reproductive organs, secondary male characteristics, reproduction, and metabolism.

What is the primary androgen?

Testosterone

List some functions of testosterone.

Helps with male puberty changes, sperm development, muscle development, bone density maintenance, and sex drive.

Why is testosterone classified as a Schedule III controlled substance?

Due to its abuse potential and illegal use for athletic enhancement.

What are anabolic steroids used for?

To increase muscle mass and improve athletic performance.

What does the term 'ergogenic' mean?

Increases muscular work capacity.

What are some risks associated with anabolic steroids, especially in adolescents?

Premature stopping of bone growth, heart damage, kidney damage, and liver damage.

What is androgen deficiency?

Insufficient testosterone production, which can be congenital or acquired later in life (hypogonadism).

Name some signs and symptoms of low testosterone.

Erectile dysfunction, infertility, decreased beard/body hair growth, decreased muscle mass, gynecomastia, and osteoporosis.

What is testosterone replacement therapy used to treat?

Testosterone deficiency and hypogonadism.

What is the mechanism of action of testosterone?

Increases nitrogen retention, protein anabolism, sodium, potassium, phosphorus retention, and decreases urinary calcium loss.

What are some adverse effects of testosterone?

Reduced sperm count, erectile changes, decreased fertility, acne, hair loss, increased sex drive, edema, hypercalcemia, jaundice, and prostate enlargement.

What are the contraindications for testosterone use?

Pregnancy, liver disease, and prostate disorders.

What is erectile dysfunction (ED)?

Difficulty initiating or maintaining an erection satisfactory for sexual activity.

What are some medical conditions that can cause ED?

Hypertension, coronary artery disease, diabetes, thyroid disease, prostate cancer, and spinal cord injury.

What lifestyle factors can contribute to ED?

Alcohol, tobacco, cocaine, and obesity.

What class of drugs are PDE-5 inhibitors?

Phosphodiesterase type 5 inhibitors.

Name two examples of PDE-5 inhibitors.

Sildenafil (Viagra) and Tadalafil (Cialis).

What is the mechanism of action of PDE-5 inhibitors?

Blocks breakdown of cyclic GMP, leading to smooth muscle relaxation, vasodilation, and increased blood flow for erection.

What are common adverse effects of PDE-5 inhibitors?

Headache, facial flushing, dyspepsia, nasal congestion, and dizziness.

What serious adverse effects can PDE-5 inhibitors cause?

Hearing loss, tinnitus, and priapism.

What is the major contraindication for PDE-5 inhibitors?

Never combine with nitrates (e.g., nitroglycerin) due to the risk of severe hypotension.

What is benign prostatic hyperplasia (BPH)?

Benign enlargement of the prostate gland.

What is the main driver of BPH?

DHT (dihydrotestosterone) causes prostate tissue growth.

List some symptoms of BPH.

Urinary frequency, urgency, hesitancy, weak urine stream, dribbling, and nocturia.

What are the three major classes of BPH medications?

5-alpha reductase inhibitors, alpha-1 adrenergic antagonists.

What is the mechanism of action of finasteride?

Blocks conversion of testosterone to DHT, leading to decreased prostate cell growth and improved urine flow.

What are some adverse effects of finasteride?

Impotence, gynecomastia, decreased libido, ejaculation problems, and decreased sperm count.

What should patients taking tamsulosin be cautious of?

Orthostatic hypotension and the need to notify surgeons before cataract surgery.

How long may it take for BPH medications to show maximum benefit?

6-12 months.