Hypogonadism a success story The patient perspective

1
Hypogonadism a success story? The patient
perspective

• Sue Cox
• Endocrine CNS, Torbay Hospital
• Ross Taylor
• Patient

2
Outline

• Overview of patient history and treatment
• Patient thoughts
• Questions

3
Patient history

• Presented Feb 06 age 41
• Single
• Security officer (airport on nights)
• Ex smoker
• Normal full term delivery. 2 brothers
• Small testes
• Remainder secondary sexual characteristics normal
• PMH
• Mumps
• Pneumonia

4
Symptoms

• Low libido
• Normal morning erection
• Physical strength reduced
• Lack of confidence
• Occasional aggression
• Slow beard growth

• Height 192.5 cms
• Weight 137.8 kgs
• Differential diagnoses
• Klinefelters
• Mumps orchitis

5
Investigations

• Testosterone
• FSH
• LH
• Prolactin
• Sperm count
• Klinefelters genotyping
• DEXA scan

• 7.8 (9.9 - 27.8)
• 27.5 (1.5 12.4)
• 19.5 (1.7 8.6)
• 232 (0 650)
• X 2 no spermatozoa seen
• Confirmed as 47,XXY
• Normal BMD

6
Treatment

• Initially felt none required
• AMS indicated general well being and mood issues
• Testogel 50mg od July 06
• Good effect
• July 07 occasional missed doses
• Noticed the change
• Asked to swap
• Changed to Nebido
• More consistent effect
• Continues on 10 weekly injections

7
Testosterone level
8
Over to Ross
9
Questions Thank you