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ISSM Issues Testosterone Deficiency Guidelines

ISSM Issues Testosterone Deficiency Guidelines Low testosterone has been a hot topic in the media lately. Advertisements ask men if they might have “low T.” Older men wonder whether testosterone replacement therapy might re-ignite their virility and sex life. And medical studies investigate possible safety risks of therapy, especially in light of cardiovascular health and prostate cancer.

In this whirlwind of information, it can be difficult for both patients and professionals to understand exactly what testosterone deficiency (TD) is, how it’s diagnosed and treated, and how it’s best managed over time.


ISSM issues testosterone deficiency guidelines. (Click to tweet)


Last month, the International Society for Sexual Medicine (ISSM) issued a “Process of Care for the Assessment and Management of Testosterone Deficiency in Adult Men.” This document explains TD based on the latest research and offers diagnosis and treatment guidelines for healthcare providers, especially those who don’t specialize in sexual medicine.

Today, we’ll answer some questions about the Process of Care, its beginnings, and its impact.


What is the ISSM and why did it issue a Process of Care?

Formed in 1978, the International Society for Sexual Medicine is a professional organization dedicated to sexual health research and education. It comprises six regional societies from around the world, including the Sexual Medicine Society of North America, the organization that produces Currently, the ISSM has about 2,200 members from 89 nations.

The ISSM noted that while formal guidelines on testosterone deficiency were available, they were somewhat dated and meant for specialists. The Process of Care addresses current concerns and is geared toward family physicians and other providers who do not specialize in sexual medicine, urology, or endocrinology.

How was the Process of Care developed?

After an extensive literature review, a panel of experts met for three days last year to discuss TD – its definition, causes, symptoms, diagnosis, treatment, and management. The group also discussed how TD affects certain populations and the current controversies surrounding testosterone replacement therapy.

For the next six months, panel members continued the conversation electronically and submitted reports on their areas of expertise. Together, the committee wrote and revised the Process of Care document.


What information does the Process of Care include?

Reading the Process of Care, professionals will learn about:

·         The definition and classification of TD

·         The physiology of testosterone

·         Causes of TD

·         Subtypes of TD

·         Diagnosis of TD, including physical examinations and lab testing

·         Assessment of TD, including questionnaires

·         Treatment - pharmacological and non-pharmacological, as well as treatment without testosterone

·         Monitoring treatment

·         Controversies (prostate cancer, cardiovascular risk)

·         Testosterone replacement therapy (TRT) in special populations (men with prostate cancer, an enlarged prostate, cardiovascular disease, obesity, metabolic syndrome, osteoporosis, or depression. Men with fertility concerns are also discussed.)

·         Cost-benefit of TRT

·         General or specialist management

What happens next?

It’s important for professionals to have updated guidelines. The Process of Care authors recommend that the document be re-evaluated and updated in four years.


How can I read the Process of Care?

Currently, the Process of Care is available as an accepted article through the Journal of Sexual Medicine website. Please click here for more details.

Print this article or view it as a PDF file here: ISSM Issues Testosterone Deficiency Guidelines


International Society for Sexual Medicine

“ISSM’s Process of Care for the Assessment and Management of Testosterone Deficiency in Adult Men”

(Press release. July 6, 2015)

Journal of Sexual Medicine

Dean. John D., FRCGP FECSM, et al.

“The International Society for Sexual Medicine's Process of Care for the Assessment and Management of Testosterone Deficiency in Adult Men”

(Full-text. Accepted for publication.)