Low Testosterone Levels in Men: What’s Really “Low” and When to Consider HRT

[madman]

DEBATE: WHAT IS A LOW TESTOSTERONE?




Professor Geoffrey Hackett

Professor Shalender Bhasin

Synthesis

 

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Benefits of Testosterone Therapy in men with Low Testosterone

 

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14 year follow up study from the EMAS data

UK Biobank study

Three main studies: T Trial, TRAVERSE and T4DM

The T Trial

 

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Long Term Cardiovascular Safety of Testosterone Therapy: A review of the TRAVERSE Study

 

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The T4DM study

T4DM Secondary outcomes at 2 years

The BLAST study

When we looked at mortality from the BLAST study

 

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Recent FDA Update

 

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Society for Endocrinology guidelines

BSSM Guidelines

Thread 'British Society for Sexual Medicine Guidelines on Male Adult TD'

Mar 9, 2023

The British Society for Sexual Medicine Guidelines on Male Adult Testosterone Deficiency, With Statements for Practice (2023)
Geoffrey Hackett, Michael Kirby, Rowland W. Rees, T. Hugh Jones, Asif Muneer, Mark Livingston, Nick Ossei-Gerning, Janine David, Jeff Foster, Philip A. Kalra, Sudarshan Ramachandran


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...

• madman
• hypogonadism; trt; testosterone; guidelines
• Replies: 15
• Forum: Testosterone and Men's Health Articles

 

[madman]

STARRR3!



What is a "Low" Testosterone Level?

The Pivotol Tenets of Endocrinology

Synthesis

Thread 'Dr. Shalender Bhasin: Optimizing the Diagnosis and Treatment of Hypogonadism 2025'

Oct 7, 2025

Nelson's house u heard it here first!

Dr. Shalender Bhasin!

* over the past 4 decades he has become a global leader in the biology of androgens, sarcopenia and aging related functional decline, his research has shaped clinical guidelines, its informed public health policy particularly around testosterone therapy, anabolic interventions and then the development of function promoting therapies




Pay attention to 25:40-34:36 of the presentation where he explains the importance of measuring free testosterone using a standardized Equilibrium Dialysis method!

Explains the...

• madman
• hypogonadism; diagnosis/treatment; trt
• Replies: 32
• Forum: Testosterone and Men's Health Articles

 

[madman]

Approaches to Defining Endocrine Disorders

 

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Generating the "Reference Sample"

 

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The BWH-CDC Collaboration to Generate harmonized Reference Ranges for Testosterone under Auspices of End Society (2009-2017)

Distribution of CDC-standardized circulating total testosterone measurements among healthy men of age 19-39 years, N =1656

* these are the statically based references ranges derived from this rigorously collected sample using harmonized LC/MS-MS assay benchmarked to a higher order calibrator. So these values are robust. They are commutable to a definable reference preparation and they are immutable.

Intercohort Variation Was Reduced by Assay Harmonization

Risk of Sexual and Physical Symptoms and Diabetes in FHS, EMAS and MrOS in Men with Low Testosterone Levels

 

[madman]

The Endocrine Society Guideline: Androgen Deficiency Syndrome in Men

The Cutpoint Should not be Viewed as an Absolute Value: Consider the Impact of Assay Imprecision

Reducing the Risk of Misclassification in the Zone of Uncertainty

Biomarkers of Testosterone Action

 

[madman]

Effect of TRT and Placebo on Sexual Activity in the TRAVERSE and TTrials

Sexual Function Does not Change When Serum T Levels are Changed within the Normal Male Range

 

[madman]

Discussion Points

Synthesis