Things to note:- Thorough medical and psychosexual history.
- Examination should exclude gynaecomastia, testicular atrophy or penile abnormalities.
- Consider the removal of drugs that may be associated with the problem.
- A change in lifestyle or drugs may resolve the problem.
Medical Treatment:Treat the underlying condition.
In patients with proven testosterone deficiency:
- Testosterone. Specialist initiated.
Screen hypogonadal men for prostate cancer before starting the replacement of testosterone.
Individualise dosage and review doses based on clinical response.
- Testosterone cyprionate, deep IM, 200-300 mg every 2-4 weeks.
Monitor prostate cancer patients as normal during the treatment.
When to refer: - Where an organic disease or medical condition is suspected as a cause.
- To a urologist or appropriate specialist if surgical intervention is needed, e.g. penile prostheses, vascular surgery and pelvic fractures.