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Testosterone in cardiometabolic and other diseases


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This book is very timely as several recent studies have demonstrated the important role of testosterone in the development of type 2 diabetes and metabolic syndrome. Testosterone is a highly controversial but vitally important hormone in men’s health. The traditional approach has been to classify low testosterone, or hypogonadism as either primary, due to disorders of the testes and therefore “classical” and meriting testosterone therapy, or secondary, where treatment may be indicated when due to structural pituitary or hypothalamic disorders. These include so-called functional causes, such as obesity, diabetes and medications where management through lifestyle change might be considered appropriate. The problem with this approach is that lifestyle changes are often either ineffective or of short-term benefit. These functional cases suffer just as readily in terms of new onset diabetes, sexual dysfunction, depression, cognitive disorders and most importantly increased mortality. The authors discuss in detail the role of testosterone and other therapeutic approaches to these problems as demonstrated by recent studies, such as T4DM, the T trials and BLAST, along with the possible impact of the long-awaited TRAVERSE study. The recent Covid-19 pandemic has caused increased mortality in men associated with profound and acute falls in testosterone that are closely linked with adverse outcomes across multiple medical disciplines. The reality is that Covid-19 is now probably the major cause of hypogonadism, with acute and long-term implications. The authors have assembled a team of international experts in andrology to address highly controversial issues in the chapters that follow.


Introduction: the politics of testosterone

David R. Edwards

Diagnosis and terminology in hypogonadism

Patricia E.S. Schartau

Issues regarding testosterone measurement and use of reference ranges in men

Mark Livingston, Rachel Marrington

Adult-onset testosterone deficiency: changes in SHBG and the role of calculated free testosterone

Richard C. Strange, Nathan Lorde, Amro Maarouf, Geoffrey I. Hackett, Sudarshan Ramachandran

Adult-onset testosterone deficiency, incident diabetes and mortality

Amro Maarouf, Nathan Lorde, Sudarshan Ramachandran

Testosterone, obesity and metabolic dysfunction

Thomas M. Barber, Hanson Petra, Martin O. Weickert

Testosterone and anaemia

Tharu Tharakan, Suks Minhas, Channa N. Jayasena

Association between haematocrit and health outcomes

Richard C. Strange, Nathan Lorde, Amro Maarouf, Geoffrey I. Hackett, Sudarshan Ramachandran

Testosterone therapy in diabetes

Geoffrey I. Hackett

Management of hypogonadism in diabetes

Geoffrey I. Hackett

Guidelines of testosterone in type 2 diabetes

Geoffrey I. Hackett

Cardiovascular benefits and risks of testosterone therapy

Geoffrey I. Hackett

The role of PDE5 inhibitors in hypogonadism and diabetes

Geoffrey I. Hackett

Hypogonadism and fertility: alternative therapies

Rowland W. Rees

Testosterone and the prostate

Rowland W. Rees

Testosterone, frailty, mood and quality of life

Adrian Heald

Osteoporosis and serum testosterone levels: the impact of testosterone therapy

Michael Kirby, Geoffrey I. Hackett

Testosterone, diabetes and COVID-19

Michael Kirby

Future developments in hypogonadism and diabetes and the role of androgen receptor sensitivity

T. Hugh Jones

Opioids, testosterone and men’s health

Janine David, Michael Kirby

Testosterone case studies

Janine David

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