The British Society for Sexual Medicine guidelines on male adult testosterone deficiency, with statements for practice
Hackett, Geoffrey Kirby, Michael Rees, Rowland W Jones, T Hugh Muneer, Asif Livingston, Mark Ossei-Gerning, Nick David, Janine Foster, Jeff Kalra, Philip A
Hackett, Geoffrey
Kirby, Michael
Rees, Rowland W
Jones, T Hugh
Muneer, Asif
Livingston, Mark
Ossei-Gerning, Nick
David, Janine
Foster, Jeff
Kalra, Philip A
Abstract
Testosterone deficiency (TD) is an increasingly common problem with significant health implications, but its diagnosis and management can be challenging. A multi-disciplinary panel from BSSM reviewed the available literature on TD and provide evidence-based statements for clinical practice. Evidence was derived from Medline, EMBASE and Cochrane searches on hypogonadism, testosterone therapy (T Therapy) and cardiovascular safety from May 2017 to September 2022. This revealed 1,714 articles, including 52 clinical trials and 32 placebo-controlled randomised controlled trials. A total of twenty-five statements are provided, relating to five key areas: screening, diagnosis, initiating T Therapy, benefits and risks of T Therapy, and follow-up. Seven statements are supported by level 1 evidence, eight by level 2, five by level 3, and five by level 4. Recent studies have demonstrated that low levels of testosterone in men are associated with increased risk of incident type 2 diabetes mellitus, worse outcomes in chronic kidney disease and COVID 19 infection with increased all-cause mortality, along with significant quality of life implications. These guidelines should help practitioners to effectively diagnose and manage primary and age-related TD.
MIDER Authors
Affiliations
Spire Hospital; Aston University; Trends in Urology and Men's Health; University of Hertfordshire & The Prostate Centre; University Hospital Southampton and UCLH; Barnsley Hospital; Royal Hallamshire Hospital; NIHR Biomedical Research Centre UCLH; Walsall Healthcare NHS Trust; Cardiff and Vale NHS Trust; University of South Wales TDS; University of Cape Coast; Portway Surgery; Salford Royal Hospital; University Hospitals Birmingham NHS Foundation Trust
Citations
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Date
2023-02-22
Type
Article
Subject
Collections
Citation
Hackett G, Kirby M, Rees RW, Jones TH, Muneer A, Livingston M, Ossei-Gerning N, David J, Foster J, Kalra PA, Ramachandran S. The British Society for Sexual Medicine Guidelines on Male Adult Testosterone Deficiency, with Statements for Practice. World J Mens Health. 2023 Jul;41(3):508-537.