Diagnosis and management of testosterone deficiency syndrome in men: clinical practice guideline

Affiliations

¹ Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta. moralesa@queensu.ca.
² Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.

PMID: 26504097
PMCID: PMC4674408
DOI: 10.1503/cmaj.150033

Review

Diagnosis and management of testosterone deficiency syndrome in men: clinical practice guideline

Alvaro Morales et al. CMAJ. 2015.

. 2015 Dec 8;187(18):1369-1377.

doi: 10.1503/cmaj.150033. Epub 2015 Oct 26.

Authors

Affiliations

¹ Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta. moralesa@queensu.ca.
² Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.

PMID: 26504097
PMCID: PMC4674408
DOI: 10.1503/cmaj.150033

No abstract available

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Figures

**Figure 1:**
Algorithm for the diagnosis of testosterone deficiency syndrome (TDS). cBAT = calculated bioavailable testosterone, CBC = complete blood count, cFT = calculated free testosterone, COPD = chronic obstructive pulmonary disease, FSH = follicle-stimulating hormone, LH = luteinizing hormone, PSA = prostate-specific antigen, SHBG = sex hormone–binding globulin, TSH = thyroid-stimulating hormone.

**Figure 2:**
Algorithm for the treatment of testosterone deficiency syndrome (TDS). *Report adverse events to MedEffect Canada (www.hc-sc.gc.ca/dhp-mps/medeff/report-declaration/index-eng.php#a2).

See this image and copyright information in PMC

Comment in

Controversies in the diagnosis and management of testosterone deficiency syndrome.
Hackett GI. Hackett GI. CMAJ. 2015 Dec 8;187(18):1342-1344. doi: 10.1503/cmaj.151208. Epub 2015 Oct 26. CMAJ. 2015. PMID: 26504104 Free PMC article. No abstract available.
Déficience en testostérone. De nouvelles lignes directrices.
Couillard K. Couillard K. Perspect Infirm. 2016 May-Jun;13(3):55. Perspect Infirm. 2016. PMID: 27403478 French. No abstract available.

References

1. Buvat J, Maggi M, Guay A, et al. Testosterone deficiency in men: systematic review and standard operating procedures for diagnosis and treatment. J Sex Med 2013;10:245–84. - PubMed
1. Bhasin S, Cunningham GR, Hayes FJ, et al. ; Task Force, Endocrine Society. Testosterone therapy in adult men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2010;95:2536–59. - PubMed
1. Wang C, Nieschlag E, Swerdloff R, et al. Investigation, treatment and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA and ASA recommendations. Eur J Endocrinol 2008; 159:507–14. - PMC - PubMed
1. Piszczek J, Mamdani M, Antoniou T, et al. The impact of drug reimbursement policy on rates of testosterone replacement therapy among older men. PLoS ONE 2014;9:e98003. - PMC - PubMed
1. Layton JB, Li D, Meier CR, et al. Testosterone lab testing and initiation in the United Kingdom and the United States, 2000 to 2011. J Clin Endocrinol Metab 2014;99:835–42. - PMC - PubMed

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Diagnosis and management of testosterone deficiency syndrome in men: clinical practice guideline

Affiliations

Diagnosis and management of testosterone deficiency syndrome in men: clinical practice guideline

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