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Testosterone Deficiency Syndrome Singapore.

Testosterone Deficiency Syndrome Singapore: Testosterone deficiency syndrome (TDS) symptoms in men clinic, Singapore. Private and confidential service. Definitions, references, and latest news.

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

References

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

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
  1. Do you have a decrease in libido (sex drive)?
  2. Do you have a lack of energy?
  3. Do you have a decrease in strength and/or endurance?
  4. Have you lost height?
  5. Have you noticed a decreased "enjoyment of life"?
  6. Are you sad and/or grumpy?
  7. Are your erections less strong?
  8. Have you noted a recent deterioration in your ability to play sports?
  9. Are you falling asleep after dinner?
  10. 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

Testosterone test - Testosterone blood level test. Testosterone treatment / testosterone replacement therapy (TRT) with a testosterone preparation:
TimeInvestigationTreatment
Before Week 0 Testosterone 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


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