Case scenario

David, a 49-year-old male, 178 cm, 93 kg, presents at the pharmacy for some advice about low testosterone levels. He states that he has been feeling lethargic, has low libido, and feels as though his strength has declined as he has gotten older. His GP had requested pathology, and David was told that his testosterone was ‘slightly low but not enough for supplementation’. David feels that testosterone will fix his issues and wishes to know how to access a prescription.

Learning objectives

After reading this article, pharmacists should be able to:

  • Explain the role of testosterone in males
  • Discuss therapies used to manage symptoms of low testosterone in males on androgen deprivation therapy
  • Describe the different forms of testosterone available in Australia on prescription
  • Describe clinically appropriate and inappropriate uses for testosterone therapy.

Competency standards (2016) addressed: 1.1, 1.4, 1.5, 2.2, 3.1, 3.5

Accreditation number: CAP2502DMTS

Accreditation expiry: 31/01/2028

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Introduction

Testosterone is a steroid hormone primarily produced in the Leydig cells of the male testes.1 To a lesser extent, it is also produced by the adrenal glands and the ovaries in females.2 Production of testosterone is controlled by luteinising hormone (LH), and follicle stimulating hormone (FSH) secreted by the pituitary gland.2 Further upstream, it is gonadotropin-releasing hormone (GnRH) from the hypothalamus that stimulates the release of LH and FSH.2 Consequently, the axis

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