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For Physicians

Over the past decade, doctors are seeing more men than ever in their medical practice. The reason is that male sexuality is finally out of the closet.  Few men know much about their bodies, so they go to a doctor  for help.

What can you, as a physicians, do for men if they have sexual dysfunction? They may have noticed a change in their sexual interest, a decrease in performance in the bedroom and some fear the dreaded threat of impotence. Men who don’t get enough of a response even with Cialis or Viagra become very worried about their erections. Androgen Guidelines Summary

If you only measure total testosterone on one or even two occasions, the tests will  provide a diagnosis of  severe hypogonadism. But most  men in whom an erection enhancer does not work, have a real problem. Almost 40% of men with ED also have hypogonadism or low free testosterone below the normal range. 

There is new evidence that testosterone deficiency is present in 33% of diabetics and almost 50% of obese men with a BMI over 35.  More recent evidence even indicates that low testosterone may trigger prostate cancer. (Morgantaller, 2008). Finally there may be a lower risk of prostate enlargement or male pattern baldness with androgen replacement using topical agents. (Ly, 2001) in place of injectable synthetic testosterone esters. You should consider androgen replacement therapy in any depressed man to improve mood and restore his sense of well-being.

Any man with lower than normal free testosterone levels in addition to symptoms of deficiency should be evaluated with a free or calculated free testosterone and all you need to test  is sex hormone binding globulin (SHBG) and total testosterone.  (Vermulen,  2008). The formula is at:  

Testosterone replacement therapy (TRT) guidelines were introduced to the field of medicine in 1996 by the AACE (American Association of Clinical Endocrinologists). .At present, male hormone replacement therapy has become standard of care and the value of TRT is currently being investigated by the government agencies in 12 centers across the country and they are enrolling men over 65 years of age.  To read more about this visit:

“In healthy subjects the bioavailable testosterone declines by approximately 1% per year between 40 and 70 years but a more pronounced decline has been observed in non-healthy groups, especially in high cardiovascular risks groups. Relative androgen deficiency is likely to have unfavourable consequences on muscle, adipose tissue, bone, haematopoiesis,fibrinolysis, insulin sensitivity, central nervous system, mood and sexual function and might be treated by an appropriate androgen supplementation.” (de Lignieres B.2002)

For men in whom erectile dysfunction was a result of low testosterone, TRT will improve erectile function without the need for erection enhancers. Testocreme® increases sensitivity and optomizes hormonal levels at low volumes.  Unlike the gels, the inclusion of the patented aromatase inhibitor, significantly increases absorption while greatly reducing the volume needed to achieve therapeutic rsults, without significant formation of undesirable hormonal metabolites, such as estradiol.

It has been postulated that estrogens also increases cancer risk and create the loss of benefits from TRT over time. Testocreme avoids this problem with variable hormone percentages, which simultaneously void the risk of  inadvertent transference to others, while raising dihydrotestosterone (DHT)  to physiologic levels. ( see abstract at end).

We now know that the age related decline of testosterone affects muscle mass and strength, bone mineral density, sexual performance, hair growth, skin thickness, lean body mass, mood, and memory. We also know this condition can be reversed through testotserone replacement.

Testocreme offers substantial flexibility for dose modification with either a 2.5, 5 or 10% formulations. Additionally, Testocreme can be applied by the patient to the scrotum without any irritation at the application site and the patient can shower within one hour. Furthermore, this formulation may be applied to a single area below the underarm minimizing transference to a sexual partner.
For an update of the current state of the art and how to recognize and treat Androgen Deficiency Syndrome, please visit: From MedscapeCME Urology–Measuring and Interpreting Serum Testosterone Levels in Men CME , by Christina Wang, MD; Ronald S. Swerdloff, MD

Physicians know that androgen supplementation was originally considered when testosterone was needed to increase sexual drive, restore strength in wasting conditions, such as HIV disease, or in dialysis patients with renal failure or after a critical illness or malignancy (Tenover, 1994). For more than a decatde, testosterone has been used to increase bone mineral density in men with osteopenia or osteoporosis (Leifke, et al. 1998) With the coining of the term, “andropause” in older men over 65, risk factors such as  chronic corticosteroid, antifungal or opiod therapy will trigger premature “andropause” (Snyder, 1999; Morley, 1997).

At present it is widely accepted that in men the quality of life,  the risk of heart disease and depression, obesity and diabetes along with other age related changes are dependent  to some degree on the level of testosterone. For a great review, check out, The Clinical Picture is one of Adult Male Hypogonadism: A Case-Based Approach by Andre T. Guay, MD. (CME Released: 10/14/2009);

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