The Curbsiders Internal Medicine Podcast #462 Male Hypogonadism Pearls with Dr. Bradley Anawalt: Insights on Testosterone Deficiency
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Nov 18, 2024 Dr. Bradley Anawalt, Chief of Medicine at the University of Washington Medical Center and an endocrinology expert, joins to unravel the complexities of male hypogonadism. They discuss the critical factors for testing testosterone levels and the importance of lifestyle changes over immediate therapy. The conversation highlights risks associated with testosterone treatments, particularly concerning prostate health and cardiovascular risks. Anawalt also addresses secondary causes of hypogonadism and emphasizes individualized patient care in treatment decision-making.
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Focus on Patient Goals and Underlying Causes
- Ask patients what they hope to achieve by getting their testosterone checked.
- Consider underlying causes of fatigue such as sleep apnea or thyroid issues.
Optimize Testosterone Testing
- Check testosterone in the early morning (7-10 am) after a six-hour fast for accurate results.
- Ensure the testosterone assay uses a normal range of approximately 300-900 ng/dL.
Discussing Libido
- When discussing libido, use plain language like "sex drive."
- Ask specific questions about frequency of thoughts about sex and interest levels.