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In 2010, the Endocrine Society published a guideline on testosterone (T) therapy (NEJM JW Gen Med Aug 1 2010 and J Clin Endocrinol Metab 2010; 95:2536). The society now has published an update, with “hypogonadism” substituting for “androgen deficiency” in the title.
The guideline makes the following recommendations:
Diagnose hypogonadism in men with symptoms and signs of T deficiency and “unequivocally and consistently low” T levels. Symptoms are divided into “specific” or “suggestive” (mostly sexual-related) and “nonspecific” (e.g., decreased energy). Two fasting T measurements on separate mornings are recommended, given day-to-day variability in T levels. Diagnoses usually can be based on …