Scientifically, there is the Andrology for a long time - as an independent area of responsibility of medical-medical side, the men's medicine has established itself in recent decades. Physicians and scientists have founded the German Society for Andrology (DGA) to meet this task.
Focus of andrology
Andrologists are found in many branches of medicine - in urology, internal medicine / endocrinology and dermatology. For some years now, it has been stipulated in the continuing education regulations that physicians can acquire a qualified additional training as an Andrologist. This enables the patient to find a better orientation in the search for a competent contact person.
Andrology is mainly concerned with
- the disorders of fertility (infertility),
- the disorders of hormone formation in the testes (hypogonadism),
- Erectile dysfunction disorders (erectile dysfunction),
- male contraception and contraception
- the aging processes of the man (senescence).
Infertility - Disorders of fertility
The reproductive functions of the man (that is, the capacity for procreation) and their disorders constitute an important focus of andrology. As a partner of the gynecologist, andrologists may be significantly involved in the detection and treatment of disorders of male fertility. In addition to the long-standing methods of artificial insemination and sperm treatment, approximately 15 years ago, the treatment of severe male birth defects was significantly improved by assisted fertilization using intracytoplasmic sperm injection technique (ICSI).
Surgical methods of sperm retrieval and microsurgical treatment techniques have been optimized. According to the guidelines of the German Medical Association, andrologen today have to be integrated into every reproductive medical team, so that fertility treatment is always an interdisciplinary task for gynecologists and andrologists.
Hypogonadism - disorders of hormone formation of the testes
An impairment of the hormone formation of the testes (testosterone deficiency) leads to serious disorders of well-being and bodily functions (blood formation, bone metabolism, mental functions, mood, libido and erection ability). Recognizing clinically meaningful testosterone deficiency and effectively compensating for it improves the patient's quality of life and prevents serious sequelae.
The replacement therapy is tailored to the needs of the patient and performed with gel, patch or syringes. Precondition is the careful examination, the recognition of the causes and the exact knowledge about possibly existing contraindications (eg prostate cancer).
Erectile dysfunction - erectile dysfunction
Numerous disorders such as cardiovascular diseases, high blood pressure, diabetes and cancers restrict the ability to erect and lead to impotence. Conversely, the onset of erectile dysfunction may be the first indication of other underlying disorders (eg, coronary heart disease).
To clarify the causes of an erectile dysfunction and to treat it in a targeted manner, andrologen and the doctors involved in the therapy must work closely together. Therapeutically, psychotherapy, drugs (eg phosphodiesterase 5 inhibitors) and surgical procedures are used.
Contraception - contraception in men
For women there are numerous hormonal and mechanical contraceptive methods that are equally safe, have few side effects and are completely reversible at all times.
Men, on the other hand, only have vasectomy (transection of the vas deferens) as a safe method of contraception. Although this procedure can be reversed successfully in 80-90% of men by means of surgical microsurgical techniques, there remains a high residual risk that natural fertility will not be regained. Therefore, hormonal contraception is an important clinical research area of andrology.
Senescence - the aging man
Aging is a major goal - but the data on andrological problems in the elderly and old man low. The specificity of aging in women with onset of menopause is much better researched and treated clinically. Here there is still a considerable scientific and practical knowledge deficit for the man.
The aging man has special andrological diseases and a special risk profile that must be taken into account when performing therapies. The syndrome is referred to as "age hypogonadism" and can be treated successfully, taking into account internationally agreed recommendations.