Andriol® Singapore.

Andriol® Singapore: Andriol® Testocaps® (testosterone undecanoate) pills to treat andropause / late-onset hypogonadism (LOH) clinic, Singapore. Private and confidential service. Definitions, references, and latest news.

• Hypogonadism
• Andropause
• Testosterone Deficiency Syndrome (TDS)
• Testosterone Test
• Testosterone Replacement Therapy (TRT)

Testosterone treatment / testosterone replacement therapy (TRT) with a testosterone preparation:

• Testosterone injection (Nebido®)
• Testosterone gel (AndroGel®)
• Testosterone pills (Andriol® Testocaps™)

Time	Investigation	Treatment
Before Week 0	Testosterone If < 8 nmol/L - start TRT If 8-12 nmol/L - do SHBG, Testosterone calculator If < 225 pmol/L - start TRT Essential: Prostate Specific Antigen (PSA) If > 4ng/ml, check for prostate Ca Haematocrit (Hct) If > 55%, stop TRT till Hct drops to safe level. Recommended: Liver Function Test (LFT) Fasting lipids Optional: FSH LH
Week 0		Nebido® #1
Week 6		Nebido® #2
3 month (week 12)	Essential: Prostate Specific Antigen (PSA) Haematocrit (Hct)
Week 18		Nebido® #3
Before Nebido® #4 (Week 27)	Testosterone If 10-15 nmol/L - maintain interval at 12 weeks If < 10 nmol/L - decrease interval to 10 weeks If > 15 nmol/L - increase interval to 14 weeks
Week 30		Nebido® #4
9 month (week 36)	Essential: Prostate Specific Antigen (PSA) Haematocrit (Hct)
Annually	Testosterone Essential: Prostate Specific Antigen (PSA) Haematocrit (Hct) Recommended: Liver Function Test (LFT) Fasting lipids

Hypogonadism

• Male hypogonadism
• Female hypogonadism

Male hypogonadism is a clinical syndrome caused by androgen deficiency. Causes:

1. Primary hypogonadism, or hypergonadotropic hypogonadism (high LH and/or FSH), or primary testicular failure. Eg: Klinefelters syndrome, Cryptorchidism
2. Secondary hypogonadism, or hypogonadotropic hypogonadism (low LH and/or FSH), due to a defect in the hypothalamus or the pituitary.
3. Late onset hypogonadism (LOH)
4. Male hypogonadism due to androgen receptor insensitivity

Late-onset hypogonadism (LOH) is defined as hypogonadism in a person who has had normal pubertal development and as a result developed normal male secondary sex characteristics.

References

• G.R. Dohle, S. Arver, C. Bettocchi, S. Kliesch, M. Punab, W. de Ronde. Guidelines on Male Hypogonadism European Association of Urology 2012
• G.R. Dohle, S. Arver, C. Bettocchi, S. Kliesch, M. Punab, W. de Ronde. Guidelines on Male Hypogonadism II European Association of Urology 2012
• A. Morales, B. Lunenfeld. Investigation, treatment and monitoring of late-onset hypogonadism in males The Aging Male 2002;5:74-86

Andropause is the male equivalent of female menopause. Menopause in a woman literally means the end of monthly cycles. As this does not occur in a male, it refers to the stage of life when symptoms of aging appear in men. Also called symptomatic late-onset hypogonadism (SLOH), and previously referred to as androgen deficiency in aging males (ADAM)

Table 1. Questions Used as Part of the Saint Louis University ADAM Questionnaire Do you have a decrease in libido (sex drive)? Do you have a lack of energy? Do you have a decrease in strength and/or endurance? Have you lost height? Have you noticed a decreased "enjoyment of life"? Are you sad and/or grumpy? Are your erections less strong? Have you noted a recent deterioration in your ability to play sports? Are you falling asleep after dinner? Has there been a recent deterioration in your work performance? NOTE. A positive questionnaire result is defined as a "yes" answer to questions 1 or 7 or any 3 other questions.

Yes / No

Reference

• Morley JE, Charlton E, Patrick P, Kaiser FE, Cadeau P, McCready D, Perry HM 3rd. Validation of a Screening Questionnaire for Androgen Deficiency in Aging Males Metabolism. 2000 Sep;49(9):1239-42.

Testosterone deficiency syndrome (TDS) refers to the clinical signs and symptoms that result from an abnormally low testosterone level.

References

• Jacques L Tostain, François Blanc. Testosterone deficiency: a common, unrecognized syndrome Nature Reviews Urology 5, 388-396 (July 2008)

Testosterone test - Testosterone blood level test.

• Free & Bioavailable Testosterone calculator

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