What treatment is available for PADAM?

As this is a complex condition that can present itself in a variety of ways. At present, a practical approach is probably the most helpful. If multiple symptoms of PADAM are present your consultant may recommend a 'therapeutic trial' of testosterone supplement therapy for up to 3 months. If there has been no improvement in symptoms, after 3 months of therapy, then continuation of treatment is probably not worthwhile.

A very high placebo response to treatment probably occurs, so it is important to check that the improvement is maintained over time.

Men receiving testosterone supplements should have regular medical checks every 3 months for the first year of treatment, which must include a rectal examination of the prostate gland (which sits beneath the bladder producing fluids that nourish and protect sperm) and a Prostate Specific Antigen blood test. The latter two tests indicate whether or not a risk of prostate cancer exists. Abnormalities in either test should be investigated as testosterone replacement therapy is contraindicated in men with proven prostate cancer. After that period, at least yearly checks are necessary.

Testosterone is available as:

- injections (eg Nebido, Sustanon, Virormone)
- patches (eg Andropatch)
- gels (eg Testim gel, Testogel).

Capsules do not always provide steady blood levels. Patches are probably the easiest form of testosterone to use, although they are reasonably expensive.

All these preparations can only be prescribed under specialist's advice.

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