Fundamental Concepts Regarding Testosterone Deficiency and Treatment: International Expert Consensus Resolutions.
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.
Men's Health Boston and Harvard Medical School, Boston, MA. Electronic address: amorgent@yahoo.com.
Abraham
A
Morgentaler
Centre for Reproductive Medicine and Andrology, University Clinics of Muenster, Muenster, Germany.
Michael
M
Zitzmann
Department of Biochemistry and Department of Urology, Boston University School of Medicine, Boston, MA.
Abdulmaged M
AM
Traish
Pharmaceutical Medicine Group, Institute of Pharmaceutical Science, Faculty of Life Sciences and Medicine, King's College London, London, England.
Anthony W
AW
Fox
Robert Hague Centre for Diabetes and Endocrinology, Barnsley Hospital NHS Foundation Trust, Barnsley, UK.
T Hugh
TH
Jones
Sexual Medicine and Andrology Unit, University of Florence, Florence, Italy.
Mario
M
Maggi
Department of Medicine and Centre for Andrology and Sexual Medicine, Karolinska University Hospital, Stockholm, Sweden.
Stefan
S
Arver
Magna Græcia University, Catanzaro, Italy.
Antonio
A
Aversa
Hong Kong Institute of Diabetes and Obesity, Chinese University of Hong Kong, Hong Kong.
Juliana C N
JC
Chan
Johns Hopkins University School of Medicine, Baltimore, MD.
Adrian S
AS
Dobs
Good Hope Hospital, Sutton Coldfield, UK.
Geoffrey I
GI
Hackett
Section of Andrology, Department of Urology, Tulane University School of Medicine, New Orleans, LA.
Wayne J
WJ
Hellstrom
Gleneagles Hospital, Singapore, and Naval Medical School, Indonesia.
Peter
P
Lim
Faculty of Life Science, Bar Ilan University, Ramat Gan, Israel.
Bruno
B
Lunenfeld
Department of Andrology, Center for Reproductive Medicine MAMA, Moscow, Russian Federation.
George
G
Mskhalaya
Department of Urology, Erasme Hospital, Brussels, Belgium.
Claude C
CC
Schulman
Belo Horizonte, Minas Gerais, Brazil.
Luiz O
LO
Torres
D003245:Consensus Statements as Topic; D020249:Hormone Replacement Therapy / Q000009:adverse effects / Q000592:standards*; D006801:Humans; D007006:Hypogonadism / Q000188:drug therapy*; D008297:Male; D017410:Practice Guidelines as Topic / Q000592:standards; D013739:Testosterone / Q000172:deficiency*
D013739:Testosterone