male sex hormones

Question 1

androgens can be used as replacement therapy in ….

Answer 1

castrated adults and in those who are hypogonadal due to either pituitary or testicular disease

Question 1

androgens cause…

Answer 1

masculinisation

Question 2

in the normal male, androgens inhibit…… and depress …..

Answer 2

inhibit pituitary gonadotrophin secretion
depress spermatogenesis

Question 3

androgens also have anabolic action which led to the development of….

Answer 3

anabolic steroids

Question 4

androgens are useless as a treatment of impotence and impaired spermatogenesis unless

Answer 4

there is associated hypogonadism, but do not give until hypogonadism has been properly investigated. treatment should be under expert supervision

Question 5

when given to pt with hypopituitarism they can lead to ….

Answer 5

normal sexual development and potency but not to fertility

Question 6

if fertility is desired, the usual treatment is with …… which will ……

Answer 6

gonadotrophins or pulsatile gonadotrophin-releasing hormone which will stimulate spermatogenesis as well as androgen production.

Question 7

IM depot preparations of testosterone esters are preferred for….

Answer 7

replacement therapy

Question 8

examples of testosterone esters which can be preferred for replacement therapy

Answer 8

Testosterone enantate, propionate or undecanoate, or alternatively Sustanon®, which consists of a mixture of testosterone esters and has a longer duration of action, may be used.

Question 9

what is cyproterone acetate and what is it used for

Answer 9

anti-androgen used in the treatment of severe hyper sexuality and sexual deviation in the male

Question 10

how does cyproterone acetate work

Answer 10

inhibits spermatogenesis and produces reversible infertility (but is not a male contraceptive); abnormal sperm forms are produced.

Question 11

cyptoperone acetate is also licensed for use alone in pt with …

Answer 11

metastatic prostate cancer refractory to gonadorelin analogue therapy, and has been used as an adjunct in prostatic cancer and in the treatment of acne and hirsutism in women.

Question 12

dutasteride and finasteride drug class

Answer 12

5a-reductase inhibitors

Question 13

use of dutasteride and finasteride as alternatives to alpha blockers in ……

Answer 13

particularly in men with significantly larger prostate

Question 14

finasteride is licensed for use with doxazosin in …

Answer 14

management of benign prostatic hyperplasia

Question 15

1mg finasteride is also used to treat

Answer 15

male pattern baldness in men

Question 16

activity of anabolic steroids

Answer 16

some androgenic activity but they cause less virilisation than androgens in women

Question 17

anabolic steroids are used in the treatment of some

Answer 17

aplastic anaemias

Question 18

androgens are contraindicated in

Answer 18

breast cancer in males
Hx liver tumours
hypercalaemia
prostate cancer

Question 19

what to do if hypercalcaemia or hypercalciuria occurs with androgen

Answer 19

treat appropriately and restart treatment once normal serum calcium conc is restored

Question 20

common side effects of androgens

Answer 20

hot flush
hypertension
polycythaemia
prostate abnormalities
skin reactions
weight gain

Question 21

testosterone indicated for women for this indication …

Answer 21

low sexual desire in postmenopausal women (administered under expert advice)

Question 22

MHRA advice topical testosterone - risk of harm to children following accidental exposure

Answer 22

• resulting in genital enlargement and premature puberty due to increased blood testosterone levels
• repeated accidental exposure in females may also result in facial and/or body hair growth, deepening of voice and menstrual cycle changes
• counsel pt on how to reduce this risk e.g. washing hands etc

Question 23

common side effect of testosterone on lipids

Answer 23

hypertriglycerides

Question 24

directions for administration of testosterone gel

Answer 24

avoid skin contact with gel application sites to prevent accidental exposure to other people esp pregnant women and children