Male Hypogonadism: Diagnostic and Therapeutic Strategies
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This CME activity is jointly sponsored by Purdue University College of Pharmacy and Asante Communications, LLC.
Supported by an educational grant from Lilly USA, LLC. For further information concerning Lilly grant funding visit www.lillygrantoffice.com.
This activity is intended for primary care physicians and other health care providers who treat patients with male hypogonadism (MHG).
There are no prerequisites for this educational activity.
Upon completion of the educational activity participants should be better prepared to:
- Describe the signs and symptoms of MHG, and its impact on a patient’s overall health and quality of life
- Identify challenges in the differential diagnosis of MHG and review recent evidence that improves recognition in the primary care setting
- Assess the risks, benefits, and patient preferences associated with current and emerging testosterone replacement therapies
- Formulate initial and ongoing treatment regimens for MHG and restructure therapy accordingly
NEEDS ASSESSMENT AND LEARNER’S GAP
MHG is a clinical syndrome resulting from disruption at one or more levels of the hypothalamic-pituitary-gonadal axis and consequent failure of the testes to produce physiologic levels of testosterone (Bhasin et al, 2006). Although reduced testosterone levels are often considered a problem restricted predominately to older men (about 50% of men ≥85 years), significant numbers of middle-aged men are also hypogonadal (Mulligan et al, 2006). Projections estimate that more than 6.5 million American men between the ages of 30 and 79 will be hypogonadal by 2025, an increase likely to exert a considerable burden on patients and society (Araujo et al, 2007).
Sexual symptoms including decreased libido and erectile dysfunction are considered the cardinal manifestations of androgen deficiency; however, MHG is also associated with other serious illnesses commonly encountered in the primary care setting. For example, risk of cardiovascular disease, diabetes, osteoporosis, depression, and all-cause mortality is significantly higher among patients with MHG (Araujo et al, 2007; Mulligan et al, 2006).
Despite significantly reduced quality of life and high morbidity among MHG patients, symptoms are often vague and misperceptions about MHG exist (Anderson et al, 2002; Tenover, 2003). Consequently, the recognition, differential diagnosis, and knowledge of therapeutic options available to patients with MHG may be compromised and result in underrecognition and undertreatment.
Anderson JK, et al. J Gerontol A Biol Sci Med Sci. 2002;57(12):M793-M796.
Araujo AB, et al. J Clin Endocrinol Metab. 2007;92(11):4241-4247.
Bhasin S, et al. J Clin Endocrinol Metab. 2006;91(6):1995-2010.
Mulligan T, et al. Int J Clin Pract. 2006;60(7):762-769.
Tenover JS. Int J Impot Res. 2003;15(suppl 4):S1-S2.
Cynthia P. Koh-Knox, PharmD, RPh
Clinical Associate Professor of Pharmacy Practice
Faculty Liaison, Division of Continuing Education and Professional Development
Purdue University College of Pharmacy
West Lafayette, Indiana
Christopher S. Ontiveros, PhD
Asante Communications, LLC
New York, New York
METHOD OF PARTICIPATION
There are no fees for participating in and receiving credit for this activity. To receive credit, you must read the CME information (including the learning objectives and disclosures) and the article. Upon finishing the article, please complete the posttest and program evaluation form. To receive your CME certificate, you will need to pass the posttest with 70% accuracy or better. If you receive less than 70%, review the article and take the test again. After successful completion of the posttest, you will be asked to fill out the program evaluation form and prompted to print your CME certificate.
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Purdue University College of Pharmacy and Asante Communications, LLC.
Purdue University College of Pharmacy, an equal access/equal opportunity institution, is accredited by the ACCME to provide continuing medical education for physicians.
Purdue University College of Pharmacy designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CONFLICT OF INTEREST
All faculty and staff involved in the planning or presentation of continuing education activities sponsored/provided by Purdue University College of Pharmacy are required to disclose to the audience any real or apparent commercial financial affiliations related to the content of the presentation or enduring material. Full disclosure of all commercial relationships must be made in writing to the audience prior to the activity.
FACULTY/AUTHOR AND PLANNING COMMITTEE DISCLOSURES
Martin M. Miner, MD, FAAFP Abbott Laboratories (Consultant); Auxilium Pharmaceuticals, Inc. (Grants/Research Support); Boehringer Ingelheim GmbH (Consultant); GlaxoSmithKline (Grants/Research Support); Lilly USA, LLC (Consultant)
Cynthia P. Koh-Knox, PharmD, RPh Has no relevant financial relationships to disclose.
Christopher S. Ontiveros, PhD Has no relevant financial relationships to disclose.
All additional planning committee members, Purdue University College of Pharmacy and Asante Communications staff, have no relevant financial relationships to disclose.
The opinions, ideas, recommendations, and perspectives expressed in this program and accompanying materials are those of the program author and planning committee only and do not necessarily reflect the opinions, ideas, recommendations, or perspectives of their affiliated institutions, Purdue University College of Pharmacy, Asante Communications, LLC, or the activity’s commercial supporters.
Copyright© 2012 Purdue University College of Pharmacy and Asante Communications, LLC.
All rights reserved. No part of this report may be used or reproduced in any manner whatsoever without written permission except in the case of brief quotations embedded in articles or reviews.