As men age the serum testosterone slowly declines and some men develop symptoms associated with hypogonadism. The American College of Physicians has reported indications for testosterone therapy for age-related low testosterone in men.
Testosterone therapy is indicated if all of the following are present:
(1) older male with low serum testosterone
(2) sexual dysfunction
(3) goal to improve sexual function
Recommendations:
(1) The patient should be evaluated periodically. The testosterone should be discontinued if there is no improvement in sexual function.
(2) Intramuscular injection is more cost effective than transdermal.
Although not given as a recommendation, occurrence of a serious adverse effect would also be an indication for discontinuing therapy.
Conditions not considered indications for testosterone therapy:
1) to improve energy or vitality
(2) to improve physical function
(3) to improve cognition
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