Endocrine Society Updates Testosterone Therapy Guidelines

The Endocrine Society has updated its clinical guidelines for the use of testosterone therapy in men with hypogonadism.

First published in 2010, the guidelines address the diagnosis and management of hypogonadism and indicate which patient populations would and would not benefit from the therapy.

The following recommendations are included in the new guideline:

  • A diagnosis of hypogonadism should be made only in men with symptoms consistent with testosterone deficiency and unequivocally and consistently low serum testosterone concentrations.
  • Measure fasting morning total testosterone concentrations using an accurate and reliable assay as the initial diagnostic test. Confirm the diagnosis by repeating the measurement.
  • Men with androgen deficiency should receive additional diagnostic evaluation to determine the cause of androgen deficiency.
  • Testosterone therapy is recommended for men with symptomatic testosterone deficiency for the maintenance of secondary sex characteristics and the correction of hypogonadism symptoms.
  • Men who are planning fertility in the near future or who have breast or prostate cancer or various other conditions should not receive testosterone therapy.
  • When clinicians institute testosterone therapy, they should aim to achieve concentrations in the mid-normal range during treatment.

“Clinicians should monitor men receiving receiving T therapy should be monitored using a standardized plan that includes: evaluating symptoms, adverse effects, and compliance; measuring serum T and hematocrit concentrations; and evaluating prostate cancer risk during the first year after initiating T therapy,” the authors conclude.

Click here to view the full version of the updated guideline.

—Christina Vogt


Bhasin S, Brito JP, Cunningham GR, et al. Testosterone therapy in men with hypogonadism: an endocrine society clinical practice guideline [Published online March 17, 2018]. J Clin Endocrinol Metab.