Fundamental Concepts Regarding Testosterone Deficiency and Treatment: International Expert Consensus Resolutions

To address widespread concerns regarding the medical condition of testosterone (T) deficiency (TD) (male hypogonadism) and its treatment with T therapy, an international expert consensus conference was convened in Prague, Czech Republic, on October 1, 2015. Experts included a broad range of medical specialties including urology, endocrinology, diabetology, internal medicine, and basic science research. A representative from the European Medicines Agency participated in a nonvoting capacity. Nine resolutions were debated, with unanimous approval: (1) TD is a well-established, clinically significant medical condition that negatively affects male sexuality, reproduction, general health, and quality of life; (2) symptoms and signs of TD occur as a result of low levels of T and may benefit from treatment regardless of whether there is an identified underlying etiology; (3) TD is a global public health concern; (4) T therapy for men with TD is effective, rational, and evidence based; (5) there is no T concentration threshold that reliably distinguishes those who will respond to treatment from those who will not; (6) there is no scientific basis for any age-specific recommendations against the use of T therapy in men; (7) the evidence does not support increased risks of cardiovascular events with T therapy; (8) the evidence does not support increased risk of prostate cancer with T therapy; and (9) the evidence supports a major research initiative to explore possible benefits of T therapy for cardiometabolic disease, including diabetes. These resolutions may be considered points of agreement by a broad range of experts based on the best available scientific evidence.

Mayo Clinic proceedings. 2016 Jun 10 [Epub ahead of print]

Abraham Morgentaler, Michael Zitzmann, Abdulmaged M Traish, Anthony W Fox, T Hugh Jones, Mario Maggi, Stefan Arver, Antonio Aversa, Juliana C N Chan, Adrian S Dobs, Geoffrey I Hackett, Wayne J Hellstrom, Peter Lim, Bruno Lunenfeld, George Mskhalaya, Claude C Schulman, Luiz O Torres

Men's Health Boston and Harvard Medical School, Boston, MA. Electronic address: ., Centre for Reproductive Medicine and Andrology, University Clinics of Muenster, Muenster, Germany., Department of Biochemistry and Department of Urology, Boston University School of Medicine, Boston, MA., Pharmaceutical Medicine Group, Institute of Pharmaceutical Science, Faculty of Life Sciences and Medicine, King's College London, London, England., Robert Hague Centre for Diabetes and Endocrinology, Barnsley Hospital NHS Foundation Trust, Barnsley, UK., Sexual Medicine and Andrology Unit, University of Florence, Florence, Italy., Department of Medicine and Centre for Andrology and Sexual Medicine, Karolinska University Hospital, Stockholm, Sweden., Magna Græcia University, Catanzaro, Italy., Hong Kong Institute of Diabetes and Obesity, Chinese University of Hong Kong, Hong Kong., Johns Hopkins University School of Medicine, Baltimore, MD., Good Hope Hospital, Sutton Coldfield, UK., Section of Andrology, Department of Urology, Tulane University School of Medicine, New Orleans, LA., Gleneagles Hospital, Singapore, and Naval Medical School, Indonesia., Faculty of Life Science, Bar Ilan University, Ramat Gan, Israel., Department of Andrology, Center for Reproductive Medicine MAMA, Moscow, Russian Federation., Department of Urology, Erasme Hospital, Brussels, Belgium., Belo Horizonte, Minas Gerais, Brazil.

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