Testosterone Therapy in Men with Androgen Deficiency Syndromes: An Endocrine Society Clinical Practice Guideline

Introduction:  A Task Force was created by The Endocrine Society to provide guidelines for evaluating and treating androgen deficiency syndromes in adult men.

This summary will focus on the evaluation portion of the guidelines, including symptoms, factors that affect SHBG levels, and the diagnostic process.

Summary of Evidence-based Androgen Deficiency Syndromes Evaluation Guidelines
Signs and Symptoms
Because many of the signs and symptoms of androgen deficiency are non-specific and are modified by several factors (including age, comorbid illness, and previous testosterone therapy), diagnosing androgen deficiency can be difficult.

Therefore, the Task Force identified the following list of signs and symptoms that are suggestive of androgen deficiency in men:

The following are associated with androgen deficiency in men, but they are less specific than the above list:

Conditions that Alter SHBG Concentrations
Since total testosterone levels are changed by SHBG alterations, it’s important to know what factors can change SHBG levels.

Conditions that decrease SHBG concentrations

Conditions that increase SHBG concentrations

Diagnosis
The Task Force provided the following guidelines for diagnosing androgen deficiency syndromes in men:

 

Commentary by Glenn R. Cunningham MD