Current Evidence on Late-Onset Hypogonadism in Primary Care: A Scoping Review Protocol

Fatigue, loss of energy, low sexual desire and erectile dysfunction are common in primary care, and late-onset hypogonadism (LOH), defined according to symptoms and low testosterone levels, is one possible explanation. Its symptoms are non-specific, and terminology and diagnostic thresholds vary between guidelines. Testosterone prescribing has risen in the UK, yet men requiring treatment may remain unidentified. Evidence has primarily been derived from specialist settings and intervention trials, and primary care evidence has not been systematically mapped. The aim of this scoping review is to map evidence on the frequency and clinical presentation of LOH in primary care; its recognition, assessment and management; and associated barriers and facilitators, and to identify evidence gaps relevant to primary care practice to inform future research. This review will follow JBI principles, and the outcomes will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). This review will cover primary care and general practice settings internationally. PubMed, CINAHL and Web of Science Core Collection will be searched for peer-reviewed, original research published in English from 2000 onwards. Two reviewers will independently screen titles/abstracts and full texts, with disagreements resolved by discussion or a third reviewer. Data will be extracted by one reviewer and verified by another. Descriptive and basic qualitative content analyses will be conducted. This review will clarify evidence and identify knowledge gaps concerning LOH in primary care, informing future research and guidance.