Overview on the clinical presentation and indication

Abstract Testosterone is the male hormone produced by the Leydig cells of the testis. Approximately 98% of testosterone circulates in the blood bound to protein and the remaining 2% is free. Normal level of testosterone decrease the risk of cardiovascular disease, decrease the visceral fat mass and total cholesterol, maintain glycemic control, and increase lean body mass. Semen is an organic fluid consisting of secretions of the testes and the accessory sexual glands. Semen quality is a measure of the ability of the male germ cells to accomplish fertilization and pregnancy. Decreased semen quality causes male infertility. Semen quality is influenced by lifestyle, food intake, and exposure to chemicals. The Aging Male Symptoms Score Chart is an instrument to measure the severity of aging symptoms in men, and their impact on quality of life. Erectile dysfunction (ED) is the inability to achieve or maintain an erection adequate enough for satisfactory sexual intercourse. The organic causes of ED are cardiovascular disease, diabetes, neurological problems, hormonal insufficiencies, and drug side effects. The first-line treatment of erectile dysfunction consists of a trial of phosphodiesterase-5 inhibitor. Male hypogonadism is caused by deficiency in testosterone. There are two basic types of hypogonadism, primary, which originates in the testicles, and secondary, which originates in the hypothalamus or the pituitary gland. Hypogonadism is suspected when the serum testosterone levels are less than 300 ng/dL. The prostate is an accessory sex organ that contributes about 20%–30% to the total seminal ejaculate. The prostate is 3.4 cm in length, 4.4 cm in width, 2.6 cm in thickness, and the weight is between 15 and 20 g. It is located in the pelvis. Benign prostatic hyperplasia (BPH) is a noncancerous increase in size of the prostate. BPH is a progressive disease that is commonly associated with lower urinary tract symptoms. Validated questionnaires such as the American Urological Association Symptom Index, the International Prostate Symptom Score, and the UWIN score are useful aids to making the diagnosis of BPH and quantifying the severity of symptoms. Prostate cancer is the development of cancer in the prostate. Initially it is symptomless but in later stages, it can lead to dysuria, hematuria, or pain in pelvis, back, or when urinating. About 99% of the cases occur in males over the age of 50. Prostate cancer is diagnosed by biopsy with medical imaging. Screening is done by PSA (blood test).