Andropause Mastery

Evaluation and treatment of testosterone deficiency Part 1

9 Topics | 9 Quizzes

Hypogonadism: The Basics

Quiz 1: Hypogonadism: The Basics

PADAM – Partial Androgen deficiency in the Adult Male: Dx & Causes

Quiz 2: PADAM – Partial Androgen Deficiency in the Adult Male: Dx & Causes

Prescription medications that affect the endocrine system

Quiz 3: Prescription medications that affect the endocrine system

Evaluations: Initial Medical History for Men

Quiz 4: Evaluations: Initial Medical History for Men

Evaluations: Lab Testing

Quiz 5: Evaluations: Lab Testing

Treatments: Clomiphene, hCG, and ways to lower elevated prolactin

Quiz 6: Treatments: Clomiphene, hCG, and ways to lower elevated prolactin

Attention to Estrogen Levels in Males

Quiz 7: Attention to Estrogen Levels in Males

Paying Attention to SHBG

Quiz 8: Paying Attention to SHBG

Testosterone Replenishment Options

Quiz 9: Testosterone Replenishment Options

Evaluation and treatment of testosterone deficiency Part 2

3 Topics | 3 Quizzes

Case Histories Part 1: Clomiphene & hCG Stim testing, and prolactinoma

Quiz 10: Case Histories Part 1: Clomiphene & hCG Stim Testing, and Prolactinoma

Case Histories Part 2: Elevated SHBG, Aromatase Inhibitors, and Hormone Rx for the obese

Quiz 11: Case Histories Part 2: Elevated SHBG, Aromatase Inhibitors, and Hormone Rx for the obese

Sexual dysfunction: Libido, ED and Orgasmic Response

Quiz 12: Sexual dysfunction: Libido, ED and Orgasmic Response

Evaluation and treatment of testosterone deficiency Part 3

4 Topics | 4 Quizzes

Testosterone Nomogram, Working High and Low SHBG, and Danazol

Quiz 13: Testosterone Nomogram, Working High and Low SHBG, and Danazol

Human Chorionic Gonadotropin (hCG)

Quiz 14: Human Chorionic Gonadotropin (hCG)

Introduction to Estrogen and Aromatase Inhibitors

Quiz 15: Introduction to Estrogen and Aromatase Inhibitors

More on Aromatase Inhibitors. Boosting HPT Axis: Clomiphene. Prolactin.

Quiz 16: More on Aromatase Inhibitors. Boosting HPT Axis: Clomiphene, Prolactin

PDE-5 Inhibitors

5 Topics | 5 Quizzes

The Major Anti-aging Breakthroughs of the PDE-5 Inhibitors: Overview

Quiz 17: The Major Anti-aging Breakthroughs of the PDE-5 Inhibitors: Overview

PDE-5 Inhibitors: Benefit for Treatment of Diabetes and Cardiovascular Disease

Quiz 18: PDE-5 Inhibitors: Benefit for Treatment of Diabetes and Cardiovascular Disease

PDE-5 Inhibitors: Benefit for Treatment of Cancer

Quiz 19: PDE-5 Inhibitors: Benefit for Treatment of Cancer

PDE-5 Inhibitors: Benefit for Treatment CNS and Alzheimer’s Disease

Quiz 20: PDE-5 Inhibitors: Benefit for Treatment CNS and Alzheimer’s Disease

PDE-5 Inhibitors: Additional Observations & Summary of Benefits

Quiz 21: PDE-5 Inhibitors: Additional Observations & Summary of Benefits

Monday Morning Medicine: Part 1

4 Topics | 4 Quizzes

Monday Morning Medicine: Overview of testing and treating men: Basic Workup

Quiz 22: Monday Morning Medicine: Overview of testing and treating men: Basic Workup

Monday Morning Medicine: Stimulation testing

Quiz 23: Monday Morning Medicine: Stimulation testing

Monday Morning Medicine: Injectable Testosterone

Quiz 24: Monday Morning Medicine: Injectable Testosterone

Monday Morning Medicine: Topical Testosterone

Quiz 25: Monday Morning Medicine: Topical Testosterone

Monday Morning Medicine: Part 2

1 Topic | 1 Quiz

Monday Morning Medicine: PDE-5 Inhibitors

Quiz 26: Monday Morning Medicine: PDE-5 Inhibitors

Monday Morning Medicine: Part 3

3 Topics | 3 Quizzes

Monday Morning Medicine: Therapeutics Synergistic with PDE-5 Inhibitors

Quiz 27: Monday Morning Medicine: Therapeutics Synergistic with PDE-5 Inhibitors

Monday Morning Medicine: The estrogen issue in men

Quiz 28: Monday Morning Medicine: The estrogen issue in men

Practical applications: Use of Danazol for elevated SHBG

Quiz 29: Practical applications: Use of Danazol for elevated SHBG

2 Topics | 2 Quizzes

Thyroid basics and practical applications

Quiz 30: Thyroid basics and practical applications

Thyroid continued: Selenium, Iodine, and a pearl re T3 low dose to stop hair loss

Quiz 31: Thyroid continued: Selenium, Iodine, and a pearl re T3 low dose to stop hair loss

Cardiovascular and other results of Testosterone Rx

3 Topics | 3 Quizzes

Testosterone and Risk for Cardiovascular Diseases

Quiz 32: Testosterone and Risk for Cardiovascular Diseases

Additional factors related to Hormones and Cardiovascular Diseases

Quiz 33: Additional Factors Related to Hormones and Cardiovascular Diseases

So what are the objective results of treatment with testosterone?

Quiz 34: So what are the objective results of treatment with testosterone?

Quiz 5: Evaluations: Lab Testing

Andropause Mastery Evaluation and treatment of testosterone deficiency Part 1 Evaluations: Lab Testing Quiz 5: Evaluations: Lab Testing

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Question 1 of 12

1. Question
What is NOT included in initial lab testing?
- CBC, Chemistry Profile
- Lipid Profile
- Insulin, fasting
- Free T3, Free T4, TSH
- Anti-thyroid antibodies panel
- Cortisol, DHEAS
- FSH, LH
- Testosterone, total
- Testosterone, free
- Estradiol
- SHBG
- IGF-1, IGF-1BP3
- Prolactin (after 9AM)
- PSA over age 40
- 25(OH) vitamin D – total
- Fibrinogen, hs CRP
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Question 2 of 12

2. Question
LH below 2.0 can indicate:
- Healthy testicular output
- Secondary hypogonadism
Correct

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Question 3 of 12

3. Question
What is NOT true about using nomogram to calculate free testosterone?
- It is the best approach to identify the level of free testosterone
- It is dependent on knowing total testosterone, DHT, and SHBG
- It is dependent on knowing total testosterone and SHBG
- It assists in easily identifying optimal treatment levels
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Question 4 of 12

4. Question
What is the optimal treatment range for testosterone levels with a median SHBG?
- Max: 1100/Target 800/Min 600
- Max: 1000/Target 700/Min 500
- Max: 900/Target 600/Min 400
- Max: 800/Target 500/Min 300
Correct

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Question 5 of 12

5. Question
Secondary, optional testing does NOT include:
- Ferritin, TIBC
- Coenzyme Q10
- DHT
- Lipid fractionation, homocysteine, fibrinogen
- HbA1C
- Clomiphene Stimulation Test
- Chorionic Gonadotrophin Stimulation Test
- L-dopa GH Stimulation Test
- MRI – pituitary and hypothalamus
- % free PSA if >4
- Urology consult for abnormal prostate findings
- Bone densitometry
Correct

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Question 6 of 12

6. Question
True or false: DHT levels can go up with any form of testosterone replacement:
- True
- False
Correct

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Question 7 of 12

7. Question
What is NOT true for diagnostic evaluation?
- The younger the patient, the more important the diagnostic evaluation for etiology, particularly age <40
- Clomiphene Stimulation Test for men <65 if T is low normal or suggests suppression due to age disease, medication, etc; FSH >2 and not elevated
- hCG Stimulation Test – 500 units SQ 3 x weekly for three weeks – check E2 and T for response
- It is best to combine Clomiphene with hCG to obtain definitive results
Correct

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Question 8 of 12

8. Question
What is the optimal clomiphene dosage on a Clomiphene Stimulation Test?
- 25 mg (1/2 tab) h.s. x 7 days
- 50 mg (1 tab) h.s. x 7 days
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Question 9 of 12

9. Question
What labs should be selected for a Clomiphene Stimulation Test?
- FSH, LH, Testosterone total, E2
- Testosterone total, E2
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Question 10 of 12

10. Question
Positive responses on a Clomiphene Stimulation Test do NOT include:
- Increased FSH/LH above baseline = hypothalamus/pituitary is intact
- Significant increase in testosterone >50% (testes OK) – Testosterone should reach “target level”
- Testosterone should reach “target level”
- FSH rises, LH and SHBG fall
Correct

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Question 11 of 12

11. Question
hCG (chorionic gonadotrophin stimulation) tests:
- Are good for men <70
- hCG is basically LH
- Both of the above
- None of the above
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Question 12 of 12

12. Question
What is NOT true about hCG tests?
- Chorionic gonadotrophin can also raise free T4 and free T3
- Chorionic gonadotrophin (CG) 10,000 units per vial – reconstitute with 5 cc – 0.5 cc = 1000 units
- Train patient to self-administer in anterior thigh using saline in 50 unit insulin syringe with 30 gauge 5/16” needle (painless)
- Give CG 500 units (0.25 cc) nightly, Mon-Wed-Fri for 2 weeks
- Obtain blood test for testosterone, total and E2 on the second Sat AM
- Continue CG Mon, Wed, Fri until results back (usually 1 week)
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