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Men are prescribed parenteral testosterone in dosages of 80 to 120 mg intramuscularly (IM) per weekfor 10 weeks at a dose of 400 mg daily. However, they may be given a single dose of testosterone gel as a subcutaneous injection on a single occasion (eg, 3-4 times per week) when the patient is unable to or unwilling to take his or her own tablets. Because of the considerable variability in the response to IM testosterone, patients with certain medical conditions (eg, low testosterone) should be advised to be monitored closely for adverse effects such as weight gain and low serum free testosterone when initiating this treatment. It is important to remember that this is a reversible medication; however, many patients experience a reduction in their libido and/or testosterone levels (usually 5 to 10%) as their symptoms subside. Patients with severe erectile problems may need to take a regimen of non-steroidal anti-inflammatories (eg, warfarin, aspirin), which may also cause the patient to lose muscle mass and/or lose strength; there is no data to suggest that it is associated with adverse side effects. Patients should be advised not to take testosterone in conjunction with other drugs to treat their diabetes, such as insulin; they should be instructed not to use oral diuretics or antihypertensive medications since the estrogenic effects of these medications may cause an increase in the amount of testosterone available for secretion into the blood thereby increasing the risk of prostate cancer. For the evaluation of the patient's sexual function, a clinical examination, including measurements of breast tissue and seminal vesicles, is preferred. For male fertility, ultrasound can be useful but may not be helpful as testosterone stimulates the release of LH and FSH. Laboratory findings, including serum prostate-specific antigen, serum albumin, total T, and testosterone, may appear normal to the naked eye and are therefore considered irrelevant of normal male fertility . In terms of treatment of erectile function, it is important to distinguish between a primary state (eg, "high testosterone" as was mentioned above) and secondary symptoms (eg, secondary hypogonadism, delayed ejaculation) . In case of a primary state, patients should be examined for gynecomastia, sexual performance problems, and decreased libido. The primary condition is usually self-reported according to the patient's age, smoking status, and family history. In most cases, secondary conditions are self-reported and usually have a similar etiology (eg, an abnormal serum free testosterone level). In general, patients with low testosterone who wish Similar articles: