Volume 16, Number 3Review ArticlesManagement of Erectile Dysfunction in the Hypogonadal Man: A Case-Based ReviewManagement ReviewJason M ScovellRanjith RamasamyNathan A WilkenJason R KovacLarry I LipshultzErectile dysfunction (ED) has emerged as an important marker of cardiovascular and overall health, independent of other known conventional risk factors. ED often precedes coronary artery disease in half of affected subjects, and could indicate the presence of cardiovascular pathology. The pathophysiology and role of androgens in sexual function are described, along with the relevant literature on the effects of aging in erectile and gonadal function. The concept of testosterone supplementation (TST) in men with ED is reviewed. The authors utilize clinical vignettes to discuss the appropriate management of two clinical cases of men at different life stages who have ED in the setting of hypogonadism and propose a treatment algorithm. In patients of all ages, proper identification of the underlying pathophysiology of decreased libido and erectile function is paramount in choosing between the use of TST, phosphodiesterase type 5 inhibitors, or both, in the management of these disorders. [Rev Urol. 2014;16(3):105-109 doi: 10.3909/riu0623] © 2014 MedReviews®, LLCHypogonadismErectile dysfunctionTestosterone supplementationPhosphodiesterase
Volume 17, Number 4Review ArticlesCan Serum Testosterone Be Used as a Marker of Overall Health?Health Screening UpdateMichael A MederosAaron M BernieJason M ScovellRanjith RamasamyLow serum testosterone has been associated with obesity, type 2 diabetes, metabolic syndrome, and atherosclerosis. Individuals with these comorbidities are at increased risk of premature death and other adverse health effects. Clinical data portend low testosterone as a risk factor for developing these conditions which are supported by the hypogonadal-obesity-adipocytokine hypothesis. The authors support comprehensive evaluation for these comorbid conditions in men found to have low serum testosterone. [Rev Urol. 2015;17(4):226-230 doi: 10.3909/riu0674] © 2016 MedReviews®, LLCDiabetesAndrogen deficiencyAging maleComorbiditiesCardiovascular disease