Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline
Abstract
OBJECTIVE: To update the "Testosterone Therapy in Men With Androgen Deficiency Syndromes" guideline published in 2010.
PARTICIPANTS: The participants include an Endocrine Society-appointed task force of 10 medical content experts and a clinical practice guideline methodologist.
EVIDENCE: This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation approach to describe the strength of recommendations and the quality of evidence. The task force commissioned two systematic reviews and used the best available evidence from other published systematic reviews and individual studies.
CONSENSUS PROCESS: One group meeting, several conference calls, and e-mail communications facilitated consensus development. Endocrine Society committees and members and the cosponsoring organization were invited to review and comment on preliminary drafts of the guideline.
CONCLUSIONS: We recommend making a diagnosis of hypogonadism only in men with symptoms and signs consistent with testosterone (T) deficiency and unequivocally and consistently low serum T concentrations. We recommend measuring fasting morning total T concentrations using an accurate and reliable assay as the initial diagnostic test. We recommend confirming the diagnosis by repeating the measurement of morning fasting total T concentrations. In men whose total T is near the lower limit of normal or who have a condition that alters sex hormone-binding globulin, we recommend…
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