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Diagnosis and management of testosterone deficiency
James A McBride, Culley C Carson, Robert M Coward1
1Department of Urology, University of North Carolina School of Medicine, NC, USA.
Asian Journal of Andrology
|December 24, 2014
Summary
Testosterone deficiency (TD) diagnosis and treatment remain complex despite increased testosterone supplementation therapy (TST) use. This review clarifies current strategies for diagnosing and managing TD, addressing challenges in interpretation and monitoring.
Area of Science:
- Endocrinology
- Andrology
- Pharmacology
Background:
- Testosterone supplementation therapy (TST) use has surged due to new agents, marketing, and rising testosterone deficiency (TD) incidence.
- Ambiguity persists regarding TD diagnostic criteria, TST administration, and monitoring due to testosterone's complex physiological roles.
- Medical comorbidities and medications can alter testosterone levels, presenting nonspecific signs and symptoms, complicating diagnosis.
Purpose of the Study:
- To provide a clear description of current strategies for diagnosing and managing testosterone deficiency (TD).
Main Methods:
- Review of current literature and guidelines on testosterone deficiency (TD) diagnosis and management.
- Analysis of challenges in diagnosing TD, including nonspecific symptoms and assay inconsistencies.
- Evaluation of various testosterone supplementation therapy (TST) agents and their nuances.
Main Results:
- Diagnostic criteria for TD lack definitive consensus, differing among medical societies and expert opinions.
- Serum total testosterone levels do not reliably correlate with symptoms, particularly in aging males.
- Inconsistencies between laboratory assays further complicate accurate TD diagnosis.
Conclusions:
- Clinicians face challenges in staying updated on TD diagnosis and TST due to evolving agents and diagnostic complexities.
- A clear understanding of current diagnostic and management strategies is crucial for effective TST.
- Further research may be needed to standardize TD diagnosis and optimize TST protocols.
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