Late-onset Hypogonadism and Testosterone Therapy - A Summary of Guidelines from the American Urological Association and the European Association of Urology

Abstract

Men with low serum testosterone and symptoms of androgen deficiency may be diagnosed with testosterone deficiency. This condition is associated with metabolic syndrome and cardiovascular disease. The benefits (eg, improvement in sexual function) and risks (eg, prostate cancer and cardiovascular disease) of testosterone therapy are controversial. The American Urological Association and European Association of Urology guidelines on testosterone therapy differ on several points of management, likely reflecting the ambiguities surrounding testosterone therapy in practice. This paper summarizes both guidelines with a focus on the differences between the two sets of guidelines. PATIENT SUMMARY: The benefits and risks of testosterone therapy are controversial, as reflected in the European Association of Urology and American Urological Association guidelines that differ on several points of management.

Keywords: Androgens; Erectile dysfunction; Hypogonadism; Libido; Lifestyle; Major cardiac adverse event; Prostate cancer; Sexual desire; Testosterone; Testosterone deficiency; Testosterone replacement therapy.