Society for Endocrinology guidelines for testosterone replacement therapy in male hypogonadism
Open accessAbstract
Male hypogonadism (MH) is a common endocrine disorder. However, uncertainties and variations in its diagnosis and management exist. There are several current guidelines on testosterone replacement therapy that have been driven predominantly by single disciplines. The Society for Endocrinology commissioned this new guideline to provide all care providers with a multidisciplinary approach to treating patients with MH. This guideline has been compiled using expertise from endocrine (medical and nursing), primary care, clinical biochemistry, urology and reproductive medicine practices. These guidelines also provide a patient perspective to help clinicians best manage MH.
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Total testosterone, SHBG, free androgen index, calculated free testosterone, directly measured free testosterone, and bioactive or bioavailable testosterone do not represent interchangeable endpoints.
“Consequently, TT, SHBG, free androgen index (FAI), calculated free testosterone (calculated FT), directly measured FT, and bioactive or bioavailable testosterone do not represent interchangeable endpoints.”
Directly measured free testosterone and calculated free testosterone are analytically non-equivalent and may differ in calibration, assay performance, assumptions, and dependence on total testosterone, SHBG, and albumin.
“Directly measured FT and calculated FT were not pooled because they are analytically non-equivalent and may differ in calibration, assay performance, assumptions, and dependence on TT, SHBG, and albumin [8,9,10].”
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“energy deficits, as only small series have been reported to date and, moreover, genetic influences have not been identified.(42) Typically, such”
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“Surprisingly, other national guidelines from the United Kingdom make no mention of OSA at all [125].”
BackgroundPaez-Allendes, L., Valenzuela-Fuenzalida, J. J., Moya, M. P., Oyanedel, G., Cifuentes-Suazo, G., Figueroa-Puig, J., Orellana-Donoso, M., Mateluna-Valls, E., Cabezas-Salgado, J. J., Sanchis-Gimeno, J., et al. (2026) · Nutrients · doi:10.3390/nu18132090
- Authors
- Jayasena, C. N., Anderson, R. A., Llahana, S., Barth, J. H., MacKenzie, F., Wilkes, S., Smith, N., Sooriakumaran, P., Minhas, S., Wu, F. C. W., Tomlinson, J., & Quinton, R.
- Affiliations
- Hammersmith Hospital (GB)
- MRC Centre for Reproductive Health (GB)
- University College London Hospitals NHS Foundation Trust (GB)
- Leeds Teaching Hospitals NHS Trust (GB)
- University Hospitals Birmingham NHS Foundation Trust (GB)
- Patient member
- Department of Urology, Charing Cross Hospital Imperial College Healthcare NHS Trust London UK
- University of Manchester (GB)
- University of Oxford (GB)
- Newcastle upon Tyne Hospitals NHS Foundation Trust (GB)
- Corresponding author
- Jayasena, Channa N.
- Quinton, Richard
- ORCID
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2021-11-22
- Volume
- 96
- Issue
- 2
- Pages
- 200-219
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W3215648158
- Cited by
- 147
- References
- 24
- Citations by year
- 2026: 31 · 2025: 34 · 2024: 30 · 2023: 37 · 2022: 15
- FWCI
- 14.93
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Edinburgh Research Explorer (University of Edinburgh) (publishedVersion, other-oa)
- City Research Online (City University London) (acceptedVersion)
- Sunderland Repository (University of Sunderland) (acceptedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- National Institute for Health and Care Research (CL-2009-21-004, NIHR301286, PDF-2017-10-098, 17/68/01)
- Academy of Medical Sciences (AMS-SGCL5-Jayasena)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- male hypogonadism, testosterone replacement therapy, diagnosis, multidisciplinary care, patient perspectives, primary care, urology, reproductive medicine, clinical chemistry
- MeSH terms
- Endocrine System Diseases, Endocrinology, Humans, Hypogonadism, Male, Testosterone, Hormone Replacement Therapy
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