Volume 4, Supplement 3SupplementManaging Concomitant Cardiac Disease and Erectile DysfunctionRichard A SteinErectile dysfunctionCardiovascular diseaseCoitusMyocardial infarction
Volume 9, Number 4Review ArticlesEstrogenic Side Effects of Androgen Deprivation TherapyTreatment UpdateMichael S CooksonJames A EasthamTheresa A GuiseMichael G OefeleinMatthew R SmithCelestia HiganoAndrogen deprivation therapy (ADT) is part of standard therapy for locally advanced or metastatic prostate cancer and is frequently used in men with a rising prostate-specific antigen following radical prostatectomy or radiation therapy. In some men, ADT may be administered for years or even decades. The intended therapeutic effect of ADT is testosterone deficiency. Because estrogen is a normal metabolite of testosterone, ADT also results in estrogen deficiency. ADT has a variety of adverse effects, many of which are primarily related to estrogen deficiency. Bone mineral density may decrease by 4% to 13% per year in men receiving ADT. The fracture rate for patients on ADT averages 5% to 8% per year of therapy. Hot flashes, gynecomastia, and breast tenderness are common side effects associated with ADT. In the clinic, minimum baseline testing should include weight measurement, blood pressure reading, and fasting lipid panel and serum glucose tests. Currently, there are no large outcome trials in men on ADT testing the available therapies for adverse effects. No therapies are specifically approved for treatment of adverse effects in men on ADT. Although some therapies can be used for a single indication (based upon small studies), there is currently no agent to treat the multiple estrogenic side effects of ADT. [Rev Urol. 2007;9(4):163-180]Androgen deprivation therapyCardiovascular diseaseGynecomastiaOsteoporosis fractureMale hot flashes
Volume 12, Number 4Review ArticlesMetabolic Syndrome and Urologic DiseasesMangement ReviewHaluk AkpinarIlya GorbachinskyMetabolic syndrome (MetS) is a complex entity consisting of multiple interrelated factors including insulin resistance, central adiposity, dyslipidemia, endothelial dysfunction and atherosclerotic disease, low-grade inflammation, and in males, low testosterone levels. MetS has been linked to a number of urologic diseases including nephrolithiasis, benign prostatic hyperplasia and lower urinary tract symptoms, erectile dysfunction, male infertility, female incontinence, and prostate cancer. This article reviews the relationships between MetS and these entities. Urologists need to be cognizant of the impact that MetS has on urologic diseases as well as on overall patient health.[Rev Urol. 2010;12(4):e157-e180 doi: 10.3909/riu0487]© 2010 MedReviews®, LLCObesityMetabolic syndromeBenign prostatic hyperplasiaNephrolithiasisHypogonadismCardiovascular diseaseInsulin resistanceEndothelial dysfunction
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