TY - JOUR
T1 - Testosterone therapy in men with androgen deficiency syndromes
T2 - An endocrine society clinical practice guideline
AU - Bhasin, Shalender
AU - Cunningham, Glenn R.
AU - Hayes, Frances J.
AU - Matsumoto, Alvin M.
AU - Snyder, Peter J.
AU - Swerdloff, Ronald S.
AU - Montori, Victor M.
N1 - Funding Information:
Shalender Bhasin, M.D. (Chair)—Consultation or Advisement: GlaxoSmithKline (GSK), Merck; Grant or Other Research Support: Solvay, Ligand, Merck; Financial or Business/Organizational Interests: American Board of Internal Medicine. Glenn R. Cunningham, M.D.—Consultation or Advisement: Clarus, Columbia Lab, GSK, Indevus/Endo Pharmaceuticals, Solvay Pharmaceuticals; Grant or Other Research Support: Solvay Pharmaceuticals; Columbia Lab, GSK; Speakers List: Columbia Lab, Indevus/Endo Pharmaceuticals, Solvay Pharmaceuticals; Financial or Business/Organizational Interests: UpToDate; Significant Financial Interest or Leadership Position: none declared. Frances J. Hayes, M.B., FRCPI—Consultation or Advisement: Auxilium Pharmaceuticals, GSK, New England Research Institute; Speakers Bureau for Solvay; Financial or Business/Organizational Interests: none declared; Significant Financial Interest or Leadership Position: none declared. Alvin M. Matsumoto, M.D.— Consultation or Advisement: Solvay, Merck, Endo Pharmaceuticals, Tokai; Grant or Other Research Support: GSK, Solvay; Financial or Business/Organizational Interests: UpToDate, U.S. Anti-Doping Agency/PCC; Significant Financial Interest or Leadership Position: none declared. Peter J. Snyder, M.D.-Consultation or Advisement: none declared; Grant or Other Research Support: Solvay Pharmaceuticals; Financial or Business/Organizational Interests: Solvay, UpToDate; Significant Financial Interest or Leadership Position: UpToDate. Ronald S. Swerdloff, M.D.—Consultation or Advisement: Clarus, Solvay, Indevus; Grant or Other Research Support: Actelion Pharma, ARYx Therapeutics, Inc., Auxilium, Bayer Corp., Besins/Ascend, Bristol-Myers Squibb, Clarus, Columbia, Corcept, GSK, Eli Lilly & Co., MacroChem Corp., Organon, Schering AG, Solvay Pharmaceuticals, Inc. Co; Financial or Business/Organizational Interests: none declared; Significant Financial Interest or Leadership Position: none declared. * * Evidence-based reviews for this guideline were prepared under contract with The Endocrine Society. Victor M. Montori, M.D.—Financial or Business/Organizational Interests: none declared; Significant Financial Interest or Leadership Position: none declared.
PY - 2010/6
Y1 - 2010/6
N2 - Objective: Our objective was to update the guidelines for the evaluation and treatment of androgen deficiency syndromes in adult men published previously in 2006. Participants: The Task Force was composed of a chair, selected by the Clinical Guidelines Subcommittee of The Endocrine Society, five additional experts, a methodologist,anda medical writer. The Task Force received no corporate funding or remuneration. Conclusions: We recommend making a diagnosis of androgen deficiency only in men with consistent symptoms and signs and unequivocally low serum testosterone levels. We suggest the measurement of morning total testosterone level by a reliable assay as the initial diagnostic test. We recommend confirmation of the diagnosis by repeating the measurement of morning total testosterone and, in some men in whom total testosterone is near the lower limit of normal or in whom SHBG abnormality is suspected by measurement of free or bioavailable testosterone level, using validated assays. We recommend testosterone therapy for men with symptomatic androgen deficiency to induce and maintain secondary sex characteristics and to improve their sexual function, sense of well-being, muscle mass and strength, and bone mineral density. We recommend against starting testosterone therapy in patients with breast or prostate cancer, a palpable prostate nodule or induration or prostate-specific antigen greater than 4 ng/ml or greater than 3 ng/ml in men at high risk for prostate cancer such as African-Americans or men with first-degree relatives with prostate cancer without further urological evaluation, hematocrit greater than 50%, untreated severe obstructive sleep apnea, severe lower urinary tract symptoms with International Prostate Symptom Score above 19, or uncontrolled or poorly controlled heart failure. When testosterone therapy is instituted, we suggest aiming at achieving testosterone levels during treatment in the mid-normal range with any of the approved formulations, chosen on the basis of the patient's preference, consideration of pharmacokinetics, treatment burden, and cost. Men receiving testosterone therapy should be monitored using a standardized plan.
AB - Objective: Our objective was to update the guidelines for the evaluation and treatment of androgen deficiency syndromes in adult men published previously in 2006. Participants: The Task Force was composed of a chair, selected by the Clinical Guidelines Subcommittee of The Endocrine Society, five additional experts, a methodologist,anda medical writer. The Task Force received no corporate funding or remuneration. Conclusions: We recommend making a diagnosis of androgen deficiency only in men with consistent symptoms and signs and unequivocally low serum testosterone levels. We suggest the measurement of morning total testosterone level by a reliable assay as the initial diagnostic test. We recommend confirmation of the diagnosis by repeating the measurement of morning total testosterone and, in some men in whom total testosterone is near the lower limit of normal or in whom SHBG abnormality is suspected by measurement of free or bioavailable testosterone level, using validated assays. We recommend testosterone therapy for men with symptomatic androgen deficiency to induce and maintain secondary sex characteristics and to improve their sexual function, sense of well-being, muscle mass and strength, and bone mineral density. We recommend against starting testosterone therapy in patients with breast or prostate cancer, a palpable prostate nodule or induration or prostate-specific antigen greater than 4 ng/ml or greater than 3 ng/ml in men at high risk for prostate cancer such as African-Americans or men with first-degree relatives with prostate cancer without further urological evaluation, hematocrit greater than 50%, untreated severe obstructive sleep apnea, severe lower urinary tract symptoms with International Prostate Symptom Score above 19, or uncontrolled or poorly controlled heart failure. When testosterone therapy is instituted, we suggest aiming at achieving testosterone levels during treatment in the mid-normal range with any of the approved formulations, chosen on the basis of the patient's preference, consideration of pharmacokinetics, treatment burden, and cost. Men receiving testosterone therapy should be monitored using a standardized plan.
UR - http://www.scopus.com/inward/record.url?scp=77954409942&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77954409942&partnerID=8YFLogxK
U2 - 10.1210/jc.2009-2354
DO - 10.1210/jc.2009-2354
M3 - Review article
C2 - 20525905
AN - SCOPUS:77954409942
SN - 0021-972X
VL - 95
SP - 2536
EP - 2559
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 6
ER -