Testosterone

[text size="3"] male pt complains of symptoms consistent with hypogonadism including 
[checkbox value="decreased libido|erectile dysfunction|fatigue|reduced endurance|reduced beard growth|reduced body hair|reduced lean muscle mass|obesity|cognitive dysfunction|reduced motivation|poor concentration|poor memory|irritability|depressive symptoms|gynocomastia"]. 
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Will order the following labs today:  
[checkbox value="Hemoglobin/hematocrit|Total Testosterone|Free testosterone|Estradiol|FSH|LH|PSA"].  Will f/u with pt when studies are complete with further instructions on treatment therapy.

Discussed disease process with pt as well as different options for therapy.  Reviewed contraindications of therapy with pt including unstable heart failure, polycythemia (hematocrit > 50%|severe LUTS, existing or suspected prostate cancer, infertility,  known untreated sleep apnea, and history of cardiovascular events.  Also discussed with pt risk associated with testosterone therapy including polycthemia, VT, increasing levels of PSA and worsening LUTS, testicular atrophy and infertility, exacerbation of sleep apnea, edema, gynecomastia, risk of accelerated progression of prostate cancer, and localized skin infections.
[checkbox value="Pt would like to give self-injections at home.|Pt would like to report to clinic weekly for injections."]
[checkbox value="Discussed self-injection with pt on the day of appointment and educated pt on proper procedures. Pt educated to inject the prescribed dosage IM weekly, report back for labs as indicated in f/u. Also provided the pt with printed pt education regarding TRT therapy as well as self-injection techniques."]