madman
Super Moderator
Some of the true heavyweights here!
Introduction
General practitioners (GPs) are often the first point of contact for men with testosterone deficiency (TD), however, TD has traditionally been considered a condition reserved for specialists [1]. Various specialty societies have published guidelines, yet there are none specifically for GPs [2,3]. For reasons detailed below, we believe that TD in most cases can be best evaluated and treated by GPs. The purpose of this document is to provide a practical, clinical guide for GPs interested in treating men with TD. Note that the term GP here is intended to include other designations, such as primary care provider, which are more commonly used in some countries.
Resolution 1. General practitioners are ideally positioned to diagnose and treat testosterone deficiency
Resolution 2. TD has a negative impact on general health and quality of life
Resolution 3. Men with symptoms and/or signs of TD combined with low testosterone levels are candidates for testosterone therapy
Resolution 4. A low testosterone value is defined as total testosterone < 12 NMOL/L (350 NG/DL) and/or calculated free testosterone < 225 PMOL/L (65 PG/ML)
Resolution 5. Testosterone therapy improves metabolic health, psychological wellbeing, sexual function and quality of life
Resolution 6. Multiple testosterone formulations are available that can be tailored to patient needs
Resolution 7. Testosterone therapy does not increase the risk of prostate cancer or worsening of urinary symptoms
Resolution 8. Testosterone therapy does not increase the risk of myocardial infarction, stroke or cardiovascular death
Resolution 9. Monitoring is required for men on testosterone therapy
Resolution 10. Specific patient groups and complex cases should be referred
Conclusion
This consensus document provides a practical guide to the management of TD in primary care, including diagnosis, treatment, monitoring, and referral, when appropriate. We believe adoption of the resolutions herein will enhance men’s health on a global scale.
Introduction
General practitioners (GPs) are often the first point of contact for men with testosterone deficiency (TD), however, TD has traditionally been considered a condition reserved for specialists [1]. Various specialty societies have published guidelines, yet there are none specifically for GPs [2,3]. For reasons detailed below, we believe that TD in most cases can be best evaluated and treated by GPs. The purpose of this document is to provide a practical, clinical guide for GPs interested in treating men with TD. Note that the term GP here is intended to include other designations, such as primary care provider, which are more commonly used in some countries.
Resolution 1. General practitioners are ideally positioned to diagnose and treat testosterone deficiency
Resolution 2. TD has a negative impact on general health and quality of life
Resolution 3. Men with symptoms and/or signs of TD combined with low testosterone levels are candidates for testosterone therapy
Resolution 4. A low testosterone value is defined as total testosterone < 12 NMOL/L (350 NG/DL) and/or calculated free testosterone < 225 PMOL/L (65 PG/ML)
Resolution 5. Testosterone therapy improves metabolic health, psychological wellbeing, sexual function and quality of life
Resolution 6. Multiple testosterone formulations are available that can be tailored to patient needs
Resolution 7. Testosterone therapy does not increase the risk of prostate cancer or worsening of urinary symptoms
Resolution 8. Testosterone therapy does not increase the risk of myocardial infarction, stroke or cardiovascular death
Resolution 9. Monitoring is required for men on testosterone therapy
Resolution 10. Specific patient groups and complex cases should be referred
Conclusion
This consensus document provides a practical guide to the management of TD in primary care, including diagnosis, treatment, monitoring, and referral, when appropriate. We believe adoption of the resolutions herein will enhance men’s health on a global scale.
