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Mannlig hypogonadisme

Sist revidert:
Sist revidert av:


Definisjon:
Defineres ut fra symptomer og tegn på manglende endogen produksjon av testosteron og påvisning av lavt testosteronnivå ved blodprøve
Forekomst:
Forekommer sjelden hos barn, men er vanligere blant voksne
Symptomer:
Det kliniske bildet avhenger av om tilstanden debuterer før eller etter puberteten
Funn:
Etter puberteten medfører tilstanden hetetokter, bukfedme, nedsatt libido, erektil dysfunksjon, redusert muskelmasse og beintetthet, anemi og økt tendens til depresjoner
Diagnostikk:
Aktuelle tilleggsundersøkelser er SHBG, testosteron, FSH, LH, ev. kromosombestemmelse
Behandling:
Vanligvis parenteral testosteron eller transdermal administrering
  1. Wang C, Nieschlag E, Swerdloff R, et al. Investigation, treatment and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA and ASA recommendations. Eur J Endocrinol. 2008;159:507-514. PubMed  
  2. Svartberg JB, Jørgensen AP, Haave EM, Finnes TE. Mannlig hypogonadisme. Nasjonal veileder i endokrinologi. Publisert 30.09.2021. www.prosedyrer.no  
  3. Tajar A, Forti G, O'Neill TW, et al; EMAS Group. Characteristics of secondary, primary, and compensated hypogonadism in aging men: evidence from the European male ageing study. J Clin Endocrinol Metab. 2010;95:1810-1818. PubMed  
  4. Corona G, Lee DM, Forti G et al. Age-related changes in general and sexual health in middle-aged and older men: results from the European Male Ageing Study (EMAS). J Sex Med 2010;7:1362-80. PubMed  
  5. Wu FC, Tajar A, Beynon JM, et al. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med 2010; 363: 123-35. pmid:20554979 PubMed  
  6. Smith HS, Elliot JA. Opioid-induced androgen deficiency (OPIAD). Pain Physician 2012; 15: 145-56. pmid:22786453 PubMed  
  7. Andersen M, Arntsen SA, Eriksen EF, et al. Hypogonadisme. Norsk urologisk forenings anbefalinger for allmennleger 2013.
  8. Snyder PJ, Bhasin S, Cunningham GR, et al. Effects of testosterone treatment in older men. N Engl J Med 2016; 374: 611. pmid:26886521 PubMed  
  9. Resnick SM, et al. Testosterone treatment and cognitive function in older men with low testosterone and age-associated memory impairment. JAMA 2017; 317: 708. doi:10.1001/jama.2016.21044 DOI  
  10. Budoff MJ, et al. Testosterone treatment and coronary artery plaque volume in older men with low testosterone. JAMA 2017; 317: 708. doi:10.1001/jama.2016.21043 DOI  
  11. Barbonetti A, D'Andrea S, Francavilla S. Testosterone replacement therapy. Andrology. 2020;8(6):1551-1566. PubMed  
  12. Corona G, Rastrelli G, Morgentaler A, et al. Meta-analysis of Results of Testosterone Therapy on Sexual Function Based on International Index of Erectile Function Scores. Eur Urol 2017. pmid:28434676 PubMed  
  13. Vigen R, O’Donnell CI, Barón AE, et al. Association of testosterone therapy with mortality, myocardial infarction, and stroke in men with low testosterone levels. JAMA 2013; 310: 1829-36 Journal of the American Medical Association  
  14. Caminiti G, Volterrani M, Iellamo F, et al. Effect of long-acting testosterone treatment on functional exercise capacity, skeletal muscle performance, insulin resistance, and baroreflex sensitivity in elderly patients with chronic heart failure a double-blind, placebo-controlled, randomized study. J Am Coll Cardiol 2009; 54: 919-27. pmid:19712802 PubMed  
  15. Hudson J, Cruickshank M, Quinton R, et al. Adverse cardiovascular events and mortality in men during testosterone treatment: an individual patient and aggregate data meta-analysis. Lancet Healthy Longevity 2022; 3: 381-393. doi:10.1016/S2666-7568(22)00096-4 DOI  
  16. Walker RF, Zakai NA, MacLehose RF, et al. Association of Testosterone Therapy With Risk of Venous Thromboembolism Among Men With and Without Hypogonadism. JAMA Intern Med 2019. pmid:31710339 PubMed  
  17. Ayele HT, Brunetti VC, Renoux C, et al. Testosterone replacement therapy and the risk of venous thromboembolism: A systematic review and meta-analysis of randomized controlled trials. Thromb Res. 2021 Jan 6;199:123-131. PMID: 33486321 PubMed  
  18. Jones TH, Arver S, Behre HM, et al. Testosterone replacement in hypogonadal men with type 2 diabetes and/or metabolic syndrome (the TIMES2 study). Diabetes Care 2011; 34: 828-37. pmid:21386088 PubMed  
  19. Diem SJ, Greer NL, MacDonald R, et al. Efficacy and Safety of Testosterone Treatment in Men: An Evidence Report for a Clinical Practice Guideline by the American College of Physicians. Ann Intern Med. 2020. PMID: 31905375 PubMed  
  20. Tharu T, Saful M, Channa J, Suks M. Investigating the basis of sexual dysfunction during late-onset hypogonadism. F1000Research 2019. doi:10.12688/f1000research.16561.1 DOI  
  • Terje Johannessen, professor i allmennmedisin, Trondheim
  • Ingard Løge, spesialist allmennmedisin, redaktør NEL

Tidligere fagmedarbeidere

  • John Cooper, spesialist i allmennmedisin og indremedisin, Medisinsk avdeling, Sentralsjukehuset i Rogaland, Stavanger
  • Stein Vaaler, overlege dr. med., Senter for Klinisk Epidemiologi, Rikshospitalet, Universitetet i Oslo