Testosterone Therapy: The New Drug Seekers
The Endocrine Society and the Hormone Foundation (Bhasin et al., 2010) recommend that only symptomatic men should be evaluated for possible testosterone deficiency, and testosterone deficiency should not be diagnosed without at least two morning testosterone levels that are unequivocally low. Because there are no clear dividing lines between normal and deficient testosterone levels, it is suggested that clinicians focus on the clinical picture of the patient in its entirety and not only the numbers.
Requests from patients seeking TT purely for performance enhancement purposes should be denied. Before turning to TT, overweight men with low testosterone levels should be encouraged to lose weight through diet and exercise, and smokers should be encouraged to stop smoking. All potential candidates for TT should be made aware of the risks and make an informed decision, especially childless younger men and older men with pre-existing heart disease. Once a decision is made to initiate TT, the treatment goal is to achieve serum testosterone levels within the mid-reference range (Bhasin & Matsumoto, 2010). Men using TT should be regularly monitored for signs of untoward effects.
Guidelines for Assessment and Monitoring
The Endocrine Society and the Hormone Foundation (Bhasin et al., 2010) recommend that only symptomatic men should be evaluated for possible testosterone deficiency, and testosterone deficiency should not be diagnosed without at least two morning testosterone levels that are unequivocally low. Because there are no clear dividing lines between normal and deficient testosterone levels, it is suggested that clinicians focus on the clinical picture of the patient in its entirety and not only the numbers.
Requests from patients seeking TT purely for performance enhancement purposes should be denied. Before turning to TT, overweight men with low testosterone levels should be encouraged to lose weight through diet and exercise, and smokers should be encouraged to stop smoking. All potential candidates for TT should be made aware of the risks and make an informed decision, especially childless younger men and older men with pre-existing heart disease. Once a decision is made to initiate TT, the treatment goal is to achieve serum testosterone levels within the mid-reference range (Bhasin & Matsumoto, 2010). Men using TT should be regularly monitored for signs of untoward effects.
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