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JAMA Clinical Guidelines Synopsis
April 3, 2018

Evaluation and Treatment of Male Hypogonadism

Author Affiliations
  • 1University of Illinois at Chicago
  • 2University of Chicago, Chicago, Illinois
JAMA. 2018;319(13):1375-1376. doi:10.1001/jama.2018.3182

Men with symptoms potentially consistent with hypogonadism are frequently encountered in clinical practice. The clinical features associated with true male hypogonadism are nonspecific and include impaired libido, erections, and fertility; reductions in lean muscle mass and bone density; loss of facial, axillary, and pubic hair; anemia; and changes in mood and vitality. The effects of testosterone on energy, physical performance, mood, and cardiometabolic factors continue to be explored, but in general, the treatment of hypogonadal younger men often improves symptoms related to testosterone deficiency. In contrast, testosterone treatment for middle-aged and older men with functional decline, even for those with clearly low serum testosterone levels, offers modest and inconsistent benefit.1 Despite such uncertainties, “low T” clinics and intensive direct-to-consumer advertising have contributed to a substantial recent increase in testosterone prescribing.2

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