Review of Testosterone – Androgens (Nursing)

00:01 Hi! Welcome to our video series on men's health hormones.

00:05 I mean, I just can't help but it makes me want to go when I look at this.

00:10 We're going to talk about androgens.

00:11 Now, that's a big group of hormones men's sex characteristic hormones, but we're going to specifically go after testosterone.

00:18 So throughout the presentation you'll hear me talk about androgens and testosterone and our focus is predominantly on testosterone.

00:26 Now it's not just for males, testosterone is also present in females.

00:31 See we produce this precursor of testosterone, so it's not actually testosterone but it's a precursor of testosterone in our adrenal cortex and our ovaries.

00:41 Now, it's 10 to 40 times less testosterone than males.

00:44 But we still produce the precursor in our ovaries and adrenal cortex.

00:50 So a decrease in testosterone production happens after menopause.

00:54 So for female clients, we know that we produce a precursor of testosterone comes from our adrenal cortex and our ovaries, we have 10 to 40 times less testosterone than males and eventually of a decrease in testosterone production after menopause.

01:10 Okay, let's look at testosterone in males.

01:13 Now, the testicles are primarily make the testosterone in the leydig cells.

01:17 So females make it in the adrenal cortex and the ovaries males make it predominantly in the testicles or the leydig cells of the testicles.

01:26 Now, there's a weaker testosterone in males.

01:29 It comes from the adrenal gland, and that goes into the plasma.

01:32 Now, there's a connection look, the females in their ovaries in the adrenal cortex.

01:37 The male's testicles and also their adrenal glands.

01:41 So look for those similarities when you're studying pharmacology or any nursing concept to help your brain kind of chunk big pieces of information.

01:49 Now moving on in the male column.

01:51 There are levels decline and by the age of 80, it's at 50 percent.

01:56 I bet you probably could already guess at age 17, that's they hit their peak.

02:01 So when you're thinking about the levels, we know that most hormone levels decline over age.

02:06 Remember the female levels also decline after menopause, but with males they hit their peak at 17.

02:13 They gradually decline over their lifetime and it's about 50% by the age of 80 years.

02:19 So testosterone levels promote changes at puberty that's really important.

02:24 So put a star by that because this makes some significant changes in your bones and definitely in the rest of your body.

02:31 Testosterone levels get higher at puberty and they cause some pretty significant changes in the body.

02:38 Okay, so we're gonna look at the role of testosterone in men.

02:41 We told you that testosterone exists both in men and women, but we're going to focus predominantly on testosterone in men.

02:48 First of all, it increases bone density and also controls fat distribution.

02:53 It helps with muscle strength and mass it has facial and body hair and also helps with red blood cell production.

03:01 Now getting a little more personal it also deals with sex drive in sperm production.

03:06 So look at this slide before we go on.

03:09 Of testosterone is pretty significant in men.

03:12 This hormone, plays with lots of different processes in the body.

03:17 Now, if you want to think head to toe look we've got facial and body hair bone density, muscle strength, fat distribution, red blood cells and then the sex drive and sperm production.

03:28 So one way that you can study this is think of things head to toe.

03:33 Okay so here's a question for you.

03:35 Why do men have a higher hematocrit than women? Think about what we just talked about.

03:44 Why do men have a higher hematocrit than women? The answer is testosterone.

03:56 Testosterone promotes the synthesis of erythropoietin.

04:00 Well, how does that help? Erythropoietin is a hormone that acts on your bone marrow and that's what stimulates a red blood cell production.

04:08 So because men have higher levels of testosterone remember than women women have 10 to 40 times less, men have higher levels of testosterone compared to the women.

04:19 That's why they have higher hematocrit.

04:21 So let's roll through that one more time.

04:24 The reason men have higher hematocrit is because they have more testosterone which promotes the sins of this of more erythropoietin more erythropoietin means more red blood cells, a higher level of red blood cells, equals a higher hematocrit.

04:39 So next time you look at lab work look at the normal values for hemoglobin and hematocrit and the differences between men and women.

04:48 Now we have therapeutic uses for this hormone in both males and females.

04:53 The one that's approved is hypogonadism.

04:56 This would be in male patients that are not producing enough testosterone.

05:00 Now, there's some off-label uses for this, we can use it for the relief of menopausal symptoms with women.

05:06 Okay stop for a minute.

05:07 Why would we use? Why would we even consider using that testosterone for women? Well, because in menopause a woman's testosterone level really starts to drop off, and use of testosterone can help with some of the side effects and the adverse effects women feel during menopause.

05:24 Now, there's also an off-label use for anemias.

05:29 Now based on what we have just discussed.

05:32 Why do you think someone might consider using testosterone for an off-label use to treat anemias? Anemia means low red blood cell count and you know that testosterone synthesizes promotes that synthesis of erythropoietin which stimulates your bone marrow to make red blood cells.

05:57 That's why it's considered for an off-label use to treat anemias.

06:00 Okay let's try another question.

06:02 Why would a patient receiving testosterone have an increased risk of stroke or MI.

06:08 This one is a little trickier, think back about what you already know about testosterone in the body and how would that put me in increased risk of a stroke or an MI? Well, it's that erythropoietin again because when you have more testosterone, we've got more erythropoietin which means that you have increased amounts of red blood cells that could increase your risk of clots or thrombosis and a clot or a thrombosis can lead to a stroke or an MI.

06:44 So that's why somebody receiving testosterone does have an increased risk of having a stroke or an MI.

06:51 Now we can give androgens multiple different routes.

06:55 Look at these we've got oral by mouth.

06:58 IM as an injection and intramuscular injection yet people using aren't really a big fan of that.

07:04 But you can give a buccal we can give it Sub-Q or we can give it transdermal.

07:09 Now the Sub-Q of these implantable pellets, so you can just give that one time they kind of hang out in there.

07:15 Transdermal can be given as a gel, a patch, or a topical solution.

07:20 I want you to pay attention to the last dose there transdermal has an exclamation point by because we want you to keep in mind that when you take androgens by gel patch or topical solution you risk exposing other people to androgens if it's on your clothing if it's on your skin, so you want to be very careful about not exposing other people to androgens.