Investigation, Treatment, and Monitoring of Late‐Onset Hypogonadism in Males: ISA, ISSAM, EAU, EAA, and ASA Recommendations

Wang, Christina; Nieschlag, Eberhard; Swerdloff, Ronald S.; Behre, Hermann M.; Hellstrom, Wayne J.G.; Gooren, Louis; Kaufman, Jean‐Marc; Legros, Jean-Jacques; Lunenfeld, Bruno; Morales, Álvaro; Morley, John E.; Schulman, Claude; Thompson, Ian M.; Weidner, W.; Wu, Frederick C. W.

doi:10.2164/jandrol.108.006486

Cited by 287 publications

(254 citation statements)

References 94 publications

(181 reference statements)

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“…Wu et al recently found 17% of symptomatic hypogonadism (total testosterone less than 320 ng/dL) in a population of 3369 men between the ages of 40 and 79 years (14). These hypogonadic patients have complaints about mood, memory, impaired physical activities, weakness, diminished libido and erectile dysfunction (15,16).…”

Section: Discussionmentioning

confidence: 99%

“…A rough quantization of the minimum amount of total testosterone * chi square test Age Groups (years) necessary for nocturnal erections indicated that 200 ng/dL of total testosterone was adequate for maximal response (17). The ISSAM (International Society for the Study of Aging Male) suggests that values of total T below 200 ng/dL represent hypogonadism and should be treated (15) and men with T level between 200 ng/dL and 400 ng/dL could experience a therapeutic trial of T supplement. Despite of the fact that T therapy does not mimic the normal circadian hormone secretion, it is generally successful.…”

Section: Discussionmentioning

confidence: 99%

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Twenty-five milligrams of clomiphene citrate presents positive effect on treatment of male testosterone deficiency - a prospective study

Ros

Averbeck

2012

Int. braz j urol.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Twenty-five milligrams of clomiphene citrate presents positive effect on treatment of male testosterone deficiency - a prospective study

Ros

Averbeck

2012

Int. braz j urol.

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“…72 Diet can reduce death from coronary heart disease by up to 36% and can improve many established risk factors. 73 Consistent with the British Society for Sexual Medicine's guidelines on the management of ED, 74 the Third International Consultation of Sexual Medicine, 75 the Endocrine Society guidelines, 41 and a combined guidance of the International Society of Andrology, International Society for the Study of the Aging Male, European Association of Urology, European Academy of Andrology, and American Society of Andrology, 76 the panel agreed that a TT level greater than 350 ng/dL does not usually require substitution and that men with TT levels less than 230 ng/dL usually benefit from TRT. If there are no contraindications, symptomatic men (decreased libido or ED) with TT levels of 231 to 346 ng/dL may be considered for a 4-to 6-month trial of TRT but only after careful discussion about the potential risks and benefits.…”

Section: Treatment Additional Cardiovascular Evaluation and Referralmentioning

confidence: 97%

The Princeton III Consensus Recommendations for the Management of Erectile Dysfunction and Cardiovascular Disease

Nehra

Jackson

Miner

et al. 2012

Mayo Clinic Proceedings

417

341

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The Princeton Consensus (Expert Panel) Conference is a multispecialty collaborative tradition dedicated to optimizing sexual function and preserving cardiovascular health. The third Princeton Consensus met November 8 to 10, 2010, and had 2 primary objectives. The first objective focused on the evaluation and management of cardiovascular risk in men with erectile dysfunction (ED) and no known cardiovascular disease (CVD), with particular emphasis on identification of men with ED who may require additional cardiologic work-up. The second objective focused on reevaluation and modification of previous recommendations for evaluation of cardiac risk associated with sexual activity in men with known CVD. The Panel's recommendations build on those developed during the first and second Princeton Consensus Conferences, first emphasizing the use of exercise ability and stress testing to ensure that each man's cardiovascular health is consistent with the physical demands of sexual activity before prescribing treatment for ED, and second highlighting the link between ED and CVD, which may be asymptomatic and may benefit from cardiovascular risk reduction. T he Princeton Consensus Conference is a multispecialty collaborative tradition dedicated to optimizing sexual function and preserving cardiovascular health. The first conference convened in June 1999 to develop recommendations for clinical management of sexual dysfunction in men and women with known cardiovascular disease (CVD). This conference also provided a multidisciplinary forum for evaluation of the potential cardiovascular risk posed by sexual activity in atrisk patients. The first Princeton Consensus Conference recommendations 1 included stratification of patients by level of cardiac risk associated with sexual activity based on existing CVD. Those at low risk could initiate or resume sexual activity and be treated for sexual dysfunction. For those at high risk, sexual activity was deferred until the cardiac condition was stabilized. The second Princeton Consensus Conference convened in June 2004 and expanded the recommendations of the first conference to emphasize risk factor evaluation and lifestyle management for all men with erectile dysfunction (ED). 2 The second conference recommendations also incorporated new information on the appropriate use of phosphodiesterase type 5 (PDE5) inhibitors in men with ED and concomitant CVD.The third Princeton Consensus Conference took place November 8 to 10, 2010, in Miami Beach, Florida. The group revisited and updated their 2005 recommendations regarding the cardiovascular risk associated with sexual activity in men with known CVD. 2 In addition, the third conference focused on the predictive value of vasculogenic ED in assigning cardiovascular risk in men of all ages, with the primary objective being development of an approach to cardiovascular risk assessment in younger men with ED and no known CVD. The role of testosterone in erectile function and cardiovascular health and the utility of testosterone replacement...

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“…Finally, the availability of next-generation sequencing has started to unravel the complex molecular basis of CHH. This Consensus Statement focuses on the pathogenesis, diagnosis and treatment of CHH in light of recent discoveries and differs from existing guidelines for the treatment of hypogonadism [12][13][14] as it focuses exclusively on CHH. Definitions of several key terms used in this article are presented in the glossary (Box 1).…”

Section: Introductionmentioning

confidence: 99%

European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

et al. 2015

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| Congenital hypogonadotropic hypogonadism (CHH) is a rare disorder caused by the deficient production, secretion or action of gonadotropin-releasing hormone (GnRH), which is the master hormone regulating the reproductive axis. CHH is clinically and genetically heterogeneous, with >25 different causal genes identified to date. Clinically, the disorder is characterized by an absence of puberty and infertility. The association of CHH with a defective sense of smell (anosmia or hyposmia), which is found in ~50% of patients with CHH is termed Kallmann syndrome and results from incomplete embryonic migration of GnRHsynthesizing neurons. CHH can be challenging to diagnose, particularly when attempting to differentiate it from constitutional delay of puberty. A timely diagnosis and treatment to induce puberty can be beneficial for sexual, bone and metabolic health, and might help minimize some of the psychological effects of CHH. In most cases, fertility can be induced using specialized treatment regimens and several predictors of outcome have been identified. Patients typically require lifelong treatment, yet ~10-20% of patients exhibit a spontaneous recovery of reproductive function. This Consensus Statement summarizes approaches for the diagnosis and treatment of CHH and discusses important unanswered questions in the field.

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Investigation, Treatment, and Monitoring of Late‐Onset Hypogonadism in Males: ISA, ISSAM, EAU, EAA, and ASA Recommendations

Cited by 287 publications

References 94 publications

Twenty-five milligrams of clomiphene citrate presents positive effect on treatment of male testosterone deficiency - a prospective study

Twenty-five milligrams of clomiphene citrate presents positive effect on treatment of male testosterone deficiency - a prospective study

The Princeton III Consensus Recommendations for the Management of Erectile Dysfunction and Cardiovascular Disease

European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

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