• Clinical Practice Guideline(s)

    Testosterone Treatment

    Testosterone Treatment in Adult Men with Age-Related Low Testosterone

    (Endorsed, May 2019)

    The guideline, Testosterone Treatment in Adult Men with Age-Related Low Testosterone, was developed by the American College of Physicians and endorsed by the American Academy of Family Physicians.

    Key Recommendations

    • For individuals with age-related low testosterone and sexual dysfunction who want to improve sexual function, the decision to initiate testosterone therapy should occur following a discussion of the potential benefits, harms, costs, and patient's preferences.
    • For individuals with age-related low testosterone and sexual dysfunction who decide to initiate testosterone therapy, symptoms should be reevaluated within 12 months and treatment should be discontinued when there is no improvement in sexual function.
    • For individuals with age-related low testosterone and sexual dysfunction who decide to initiate testosterone therapy, intramuscular and transdermal formulations have similar clinical effectiveness and harms.  However, intramuscular formulations are preferred as the costs are considerably lower.
    • Testosterone therapy is not recommended in men with age-related low testosterone to improve energy, vitality, physical function, or cognition.

    These guidelines are provided only as assistance for physicians making clinical decisions regarding the care of their patients. As such, they cannot substitute the individual judgment brought to each clinical situation by the patient’s family physician. As with all clinical reference resources, they reflect the best understanding of the science of medicine at the time of publication, but they should be used with the clear understanding that continued research may result in new knowledge and recommendations. These guidelines are only one element in the complex process of improving the health of America. To be effective, the guidelines must be implemented.