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Fundamental Concepts About Testosterone Deficiency, Treatment

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. Full text

(c) 2016 Mayo Foundation for Medical Education and Research n Mayo Clin Proc. 2016;91(7):881-896

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