Hormone Therapy

ACP Releases New Testosterone Treatment Guidelines

The American College of Physicians has released a new guideline on the benefits and harms of testosterone treatment in men with age-related low testosterone.

The guidelines are based upon a systematic review of available evidence from 38 randomized controlled trials.

Among the recommendations:

  • Testosterone treatment initiation should be discussed with men with age-related low testosterone and sexual dysfunction who wish to improve sexual function (conditional recommendation; low-certainty evidence)
  • Symptoms should be reevaluated within 12 months and periodically afterward, and therapy should be discontinued in men who see no improvement in sexual function (conditional recommendation; low-certainty evidence).
  • Intramuscular rather than transdermal formulations should be considered when initiating testosterone treatment.
  • Testosterone treatment should not be initiated in men with age-related low testosterone to improve energy, vitality, physical function, or cognition (conditional recommendation; low-certainty evidence).


—Michael Potts


Qaseem A, Horwitch CA, Vijan S, et al. Testosterone treatment in adult men with age-related low testosterone: a clinical guideline from the American College of physicians [published online January 7, 2020]. Ann Intern Med. doi:10.7326/M19-0882.