Chapter 36: Men’s Health Drugs – Androgens & Treatments

The foundational male sex hormones are the androgens, primarily testosterone, which is crucial for developing and maintaining male secondary sex characteristics, stimulating bone and muscle growth through anabolic activity, and contributing to red blood cell production. When treating testosterone deficiency (hypogonadism), exogenous testosterone is often administered via transdermal or intramuscular routes to circumvent the first-pass effect. Synthetic derivatives, known as anabolic steroids, are utilized sparingly for conditions like HIV-associated wasting, but their misuse is cautioned against due to severe risks, including sterility, cardiovascular disease, and peliosis of the liver. For managing BPH, therapeutic options include 5-alpha-reductase inhibitors like finasteride, which reduce prostatic size by blocking the formation of the potent androgen DHT over several months, and alpha1-adrenergic blockers, which offer more immediate symptomatic relief. Notably, finasteride is also used for male pattern hair loss but is strictly contraindicated for handling by pregnant persons due to teratogenic potential. Treating erectile dysfunction primarily involves phosphodiesterase inhibitors (PDEIs) such as sildenafil (Viagra), which achieve erection by increasing blood flow to the penis after sexual stimulation; the most crucial safety alert for these drugs is the absolute contraindication against co-administration with nitrate medications, which can cause profound, life-threatening hypotension. The nursing process emphasizes thorough assessment of urinary patterns, cardiac history, and liver function, alongside patient education on potential adverse effects like priapism (prolonged erection requiring urgent attention) and recognizing gender-affirming care needs related to masculinizing hormone therapy.