Current National and International Guidelines for the Management of Male Hypogonadism: Helping Clinicians to Navigate Variation in Diagnostic Criteria and Treatment Recommendations

Male hypogonadism—rebadged by some as testosterone deficiency syndrome—is a clinical and biochemical diagnosis of increasing worldwide interest. Organic male hypogonadism—usually permanent—is well-established, but aging men may also exhibit lower serum testosterone levels; principally due to burden...

Full description

Bibliographic Details
Main Authors: Ahmed Al-Sharefi, Richard Quinton
Format: Article
Language:English
Published: Academya Publishing Co. 2020-09-01
Series:Endocrinology and Metabolism
Subjects:
Online Access:http://www.e-enm.org/upload/pdf/enm-2020-760.pdf
id doaj-d38fc64776c8447396aee5321f75b374
record_format Article
spelling doaj-d38fc64776c8447396aee5321f75b3742020-11-25T03:54:38ZengAcademya Publishing Co.Endocrinology and Metabolism2093-596X2093-59782020-09-0135352654010.3803/EnM.2020.7602071Current National and International Guidelines for the Management of Male Hypogonadism: Helping Clinicians to Navigate Variation in Diagnostic Criteria and Treatment RecommendationsAhmed Al-Sharefi0Richard Quinton1 Department of Endocrinology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, UK Department of Endocrinology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, UKMale hypogonadism—rebadged by some as testosterone deficiency syndrome—is a clinical and biochemical diagnosis of increasing worldwide interest. Organic male hypogonadism—usually permanent—is well-established, but aging men may also exhibit lower serum testosterone levels; principally due to burden of extra-gonadal comorbidities such as obesity, diabetes and metabolic syndrome, but with an underlying intact hypothalamo-pituitary-testicular (HPT) axis capable of springing back into operation once comorbidities are addressed. Despite encouraging observational data and plausible theoretical underpinning, evidence for efficacy and safety of testosterone in this “aging” group of men is lacking; addressing comorbid illnesses remains the key priority instead. Nevertheless, in recent years, accumulation of misleading information online has triggered a global tsunami of testosterone prescriptions. Despite this, many men with organic hypogonadism remain undiagnosed or untreated; many more face a diagnostic odyssey before achieving care by the appropriate specialist. As testosterone therapy is not without risk several clinical practice guidelines have been published specialist societies to guide physicians on best practice. However, these are heterogeneous in key areas, reflecting divergent approaches to the same evidence basis. Herein, we navigate the major clinical practice guidelines on male hypogonadism and test their respective recommendations against current best evidence.http://www.e-enm.org/upload/pdf/enm-2020-760.pdfhypogonadismtestosteronesexual dysfunctionpractice guidelinemale aging
collection DOAJ
language English
format Article
sources DOAJ
author Ahmed Al-Sharefi
Richard Quinton
spellingShingle Ahmed Al-Sharefi
Richard Quinton
Current National and International Guidelines for the Management of Male Hypogonadism: Helping Clinicians to Navigate Variation in Diagnostic Criteria and Treatment Recommendations
Endocrinology and Metabolism
hypogonadism
testosterone
sexual dysfunction
practice guideline
male aging
author_facet Ahmed Al-Sharefi
Richard Quinton
author_sort Ahmed Al-Sharefi
title Current National and International Guidelines for the Management of Male Hypogonadism: Helping Clinicians to Navigate Variation in Diagnostic Criteria and Treatment Recommendations
title_short Current National and International Guidelines for the Management of Male Hypogonadism: Helping Clinicians to Navigate Variation in Diagnostic Criteria and Treatment Recommendations
title_full Current National and International Guidelines for the Management of Male Hypogonadism: Helping Clinicians to Navigate Variation in Diagnostic Criteria and Treatment Recommendations
title_fullStr Current National and International Guidelines for the Management of Male Hypogonadism: Helping Clinicians to Navigate Variation in Diagnostic Criteria and Treatment Recommendations
title_full_unstemmed Current National and International Guidelines for the Management of Male Hypogonadism: Helping Clinicians to Navigate Variation in Diagnostic Criteria and Treatment Recommendations
title_sort current national and international guidelines for the management of male hypogonadism: helping clinicians to navigate variation in diagnostic criteria and treatment recommendations
publisher Academya Publishing Co.
series Endocrinology and Metabolism
issn 2093-596X
2093-5978
publishDate 2020-09-01
description Male hypogonadism—rebadged by some as testosterone deficiency syndrome—is a clinical and biochemical diagnosis of increasing worldwide interest. Organic male hypogonadism—usually permanent—is well-established, but aging men may also exhibit lower serum testosterone levels; principally due to burden of extra-gonadal comorbidities such as obesity, diabetes and metabolic syndrome, but with an underlying intact hypothalamo-pituitary-testicular (HPT) axis capable of springing back into operation once comorbidities are addressed. Despite encouraging observational data and plausible theoretical underpinning, evidence for efficacy and safety of testosterone in this “aging” group of men is lacking; addressing comorbid illnesses remains the key priority instead. Nevertheless, in recent years, accumulation of misleading information online has triggered a global tsunami of testosterone prescriptions. Despite this, many men with organic hypogonadism remain undiagnosed or untreated; many more face a diagnostic odyssey before achieving care by the appropriate specialist. As testosterone therapy is not without risk several clinical practice guidelines have been published specialist societies to guide physicians on best practice. However, these are heterogeneous in key areas, reflecting divergent approaches to the same evidence basis. Herein, we navigate the major clinical practice guidelines on male hypogonadism and test their respective recommendations against current best evidence.
topic hypogonadism
testosterone
sexual dysfunction
practice guideline
male aging
url http://www.e-enm.org/upload/pdf/enm-2020-760.pdf
work_keys_str_mv AT ahmedalsharefi currentnationalandinternationalguidelinesforthemanagementofmalehypogonadismhelpingclinicianstonavigatevariationindiagnosticcriteriaandtreatmentrecommendations
AT richardquinton currentnationalandinternationalguidelinesforthemanagementofmalehypogonadismhelpingclinicianstonavigatevariationindiagnosticcriteriaandtreatmentrecommendations
_version_ 1724472638891360256