Chapter 35: Men's Health Drugs

Therapeutic testosterone formulations including cypionate, enanthate, methyltestosterone, fluoxymesterone, and transdermal delivery systems address hypogonadism, delayed puberty, and select malignancies. Anabolic steroids such as oxandrolone and oxymetholone are presented for clinical applications including post-operative weight restoration, chronic wasting conditions, hereditary angioedema, and metastatic breast cancer, with emphasis on serious adverse effects from athletic misuse including infertility, cardiovascular complications, and liver damage. The chapter details androgen inhibitor mechanisms through 5-alpha reductase inhibition with finasteride and dutasteride for prostate reduction and androgenic alopecia, as well as androgen receptor antagonism and gonadotropin-releasing hormone agonists for advanced prostate malignancy. Alpha-1 adrenergic blocking agents provide rapid symptomatic relief for benign prostatic hyperplasia through smooth muscle relaxation. Erectile dysfunction pharmacotherapy emphasizes phosphodiesterase-5 inhibitors including sildenafil, tadalafil, vardenafil, and avanafil alongside prostaglandin analogs, with critical safety considerations regarding nitrate contraindications and hypotensive risk. The chapter addresses significant adverse effects including hepatic pathology, thromboembolism, cardiovascular events, priapism, gynecomastia, and reproductive dysfunction. Nursing responsibilities encompass baseline assessment of prostate-specific antigen levels, hepatic function, cardiovascular parameters, and urinary function; patient education regarding testosterone application techniques, finasteride teratogenic effects, and safe erectile dysfunction drug administration; vigilant monitoring for adverse reactions and drug interactions with anticoagulants, cyclosporine, nitrates, and antihypertensive agents; and awareness of cultural considerations in prostate cancer epidemiology and psychosocial implications of sexual dysfunction. Herbal approaches including saw palmetto are discussed with acknowledgment of limited evidence and potential drug interaction concerns.