British Society for Sexual Medicine Guidelines on Adult Testosterone Deficiency, With Statements for UK Practice.

Hackett, Geoffrey and Kirby, Michael and Edwards, David and Jones, Thomas Hugh and Wylie, Kevan and Ossei-Gerning, Nick and David, Janine and Muneer, Asif (2017) British Society for Sexual Medicine Guidelines on Adult Testosterone Deficiency, With Statements for UK Practice. The journal of sexual medicine, 14 (12). pp. 1504-1523. ISSN 1743-6109. This article is available to all HEFT staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their HEFT Athens login IDs

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Official URL: http://www.jsm.jsexmed.org/article/S1743-6095(17)3...

Abstract

BACKGROUND

Testosterone deficiency (TD) is an increasingly common problem with significant health implications, but its diagnosis and management can be challenging.

AIM

To review the available literature on TD and provide evidence-based statements for UK clinical practice.

METHODS

Evidence was derived from Medline, EMBASE, and Cochrane searches on hypogonadism, testosterone (T) therapy, and cardiovascular safety from May 2005 to May 2015. Further searches continued until May 2017.

OUTCOMES

To provide a guideline on diagnosing and managing TD, with levels of evidence and grades of recommendation, based on a critical review of the literature and consensus of the British Society of Sexual Medicine panel.

RESULTS

25 statements are provided, relating to 5 key areas: screening, diagnosis, initiating T therapy, benefits and risks of T therapy, and follow-up. 7 statements are supported by level 1, 8 by level 2, 5 by level 3, and 5 by level 4 evidence.

CLINICAL IMPLICATIONS

To help guide UK practitioners on effectively diagnosing and managing primary and age-related TD.

STRENGTHS AND LIMITATIONS

A large amount of literature was carefully sourced and reviewed, presenting the best evidence available at the time. However, some statements provided are based on poor-quality evidence. This is a rapidly evolving area of research and recommendations are subject to change. Guidelines can never replace clinical expertise when making treatment decisions for individual patients, but rather help to focus decisions and take personal values and preferences and individual circumstances into account. Many issues remain controversial, but in the meantime, clinicians need to manage patient needs and clinical expectations armed with the best clinical evidence and the multidisciplinary expert opinion available.

CONCLUSION

Improving the diagnosis and management of TD in adult men should provide somatic, sexual, and psychological benefits and subsequent improvements in quality of life. Hackett G, Kirby M, Edwards D, et al. British Society for Sexual Medicine Guidelines on Adult Testosterone Deficiency, With Statements for UK Practice. J Sex Med 2017;14:1504-1523.

Item Type: Article
Additional Information: This article is available to all HEFT staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their HEFT Athens login IDs
Subjects: WJ Urogenital system. Urology
Divisions: Planned IP Care > Urology
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Depositing User: Miss Emily Johnson
Date Deposited: 26 Jan 2018 14:45
Last Modified: 26 Jan 2018 14:45
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1579

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