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Testosterone Deficiency

Stanton C. Honig, MD and Dylan Buller, MD Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Testosterone (T) is the principle circulating androgen in males. Testosterone deficiency (TD) is characterized by low levels of T in addition to signs and symptoms.

  • No universally acc...

DIAGNOSIS

HISTORY

  • Congenital and developmental abnormalities

  • Infertility, loss of libido, erectile dysfunction

  • Depression, fatigue, difficulty with concentration

  • Decreased muscle strength, energy level

  • Inc...

TREATMENT

Testosterone therapy (TT) recommended for symptomatic men (e.g., low libido and/or erectile dysfunction, low energy level, constitutional symptoms) with low T levels ≤300 ng/dL obtained in t...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • 3 to 6 months after treatment initiation and then every 6–12 months

  • Adjust dosing to achieve a total T in the middle tertile of the normal refere...

REFERENCES

1
Mulhall  JP, Trost  LW, Brannigan  RE, et al. Evaluation and management of Testosterone deficiency: AUA guideline. J Urol.  2018;200(2):423–432. [View Abstract...

CODES

ICD10

  • E29.1 Testicular hypofunction

  • E89.5 Postprocedural testicular hypofunction

SNOMED

  • 111551000 Testicular hypofunction

  • 190552005 Postablative testicular hypofunction

  • 38825009 Deficiency of testoste...

CLINICAL PEARLS

  • TD is common, and prevalence increases with age.

  • Men with sexual dysfunction, obesity, unexplained anemia, bone density loss, chronic steroid or narcotic use, and metabolic diseases sho...

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