MONDAY, Jan. 6, 2020 (HealthDay News) — In a new evidence-based clinical practice guideline, published online Jan. 7 in the Annals of Internal Medicine, recommendations are presented for testosterone treatment in men with age-related low testosterone.

Susan J. Diem, M.D., M.P.H., from the Minneapolis VA Health Care System, and colleagues reviewed the current evidence from 38 randomized controlled trials to assess the benefits and harms of testosterone treatment for men without underlying organic causes of hypogonadism. The researchers found that testosterone therapy improved sexual functioning and quality of life, although the effect sizes were small. Little to no effect was seen for testosterone treatment on physical functioning, depressive symptoms, energy and vitality, or cognition.

Based on the evidence review, Amir Qaseem, M.D., Ph.D., from the American College of Physicians in Philadelphia, and colleagues developed guidelines for treatment. The authors recommend that for men with sexual dysfunction who may want to improve sexual function, clinicians should discuss whether to initiate testosterone; the discussion should include potential benefits, harms, costs, and patient preferences. Clinicians should reevaluate symptoms within 12 months and intermittently thereafter. For men wanting to improve sexual function, clinicians should consider intramuscular rather than transdermal formulations as costs are considerably lower. Clinicians should not initiate testosterone treatment to improve energy, vitality, physical function, or cognition for men with age-related low testosterone.

“This and other current guidelines agree that the recent increase in use of testosterone treatment for nonspecific symptoms of aging, especially in men without confirmed testosterone deficiency, is not indicated,” write the authors of an accompanying editorial.

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