The male menopause0r

The new treatment for type 2 diabetes?

Dr Colin Johnston

WHHT

Symptoms of Testosterone deficiency

• Diminished energy

• Diminished libido

• Erectile dysfunction

• Decreased muscle mass

• Increased fat mass-central

• Sleep disturbance

Symptoms of the ageing process

• Diminished energy

• Diminished libido

• Erectile dysfunction

• Decreased muscle mass

• Increased fat mass-central

• Sleep disturbance

Assessment of Testosterone deficiency

• Testosterone-9am

• SHBG-Free T. index

• Albumin-CBT

• If low or borderline-LH,FSH, Prolactin, FT4/TSH

• Age matched-’normal range’

Treatmentevidence free-zone

• Benefits-symptoms

• Risks-prostate, polycythaemia

What should we do

• Treat if diagnosis confirmed (CBT< 4, high LH,)

• Reassure the obviously normal

• ?trial of Rx for others

Monitoring

• Well-being and behaviour

• Testosterone levels

• PSA

• fbc

Treatment options

• Gels

• Depot injections

No long-term evaluation

Testosterone, insulin resistance and type 2 diabetes

What should we do

• Check testosterone-certainly in all those with ED and diabetes

• Lifestyle advise

• ? Trial of Rx-Some evidence of benefit