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Cited by 18Hormonal and reproductive studiesAdrenal Hormones and DisordersMenopause: Health Impacts and Treatments

Certainly More Guidelines than Rules

McLachlan, Robert I.·2010·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.2010-0838
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Abstract

The updated clinical practice guidelines for testosterone (T) therapy in androgen deficiency (AD) have been crafted by a panel of internationally recognized leaders in clinical practice and translational research (1). They have synthesized the current evidence and made recommendations and suggestions that align broadly with recent international guidelines (2). The evidence basis for informing clinical practice has developed only marginally; among the 45 new references cited from 2006, there are seven small to moderate-sized randomized controlled trials and several controlled studies of T responses in young vs. older men; the remainder are commentaries, meta-analyses, or epidemiological studies. With their intimate understanding of the knowledge gaps, and as required for writing summary guidelines, the authors have “filled in the blanks” with considered commentary. But consequent upon the lack of definitive data, rather vague terms (“unequivocally low”) and statements (measurement in “some” patients) necessarily appear that may obscure theoretical and pragmatic problems. These need to be recognized so that the reader is under no illusions about what is firm ground as opposed to potentially shifting sands.

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  • It is still hotly debated whether late-onset hypogonadism is a true form of hypogonadism or a decline of serum testosterone associated with the progressive accumulation of health problems with aging, rather independently of the process of aging itself.

    “It is still hotly debated whether this is a true form of hypogonadism, or a decline of serum testosterone associated with the progressive accumulation of health problems with aging (95, 96), but rather independently of the process of aging itself.”

    From Onset of effects of testosterone treatment and time span until maximum effects are achieved (2011) · cites this paper as [96]

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Authors
McLachlan, R. I.
Affiliations
Monash Medical Centre (AU)
Corresponding author
McLachlan, Robert I.
ORCID
McLachlan, Robert I.
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2010-06-01
Volume
95
Issue
6
Pages
2610-2613
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jc.2010-0838
OpenAlex
W1963599487
Cited by
18
References
24
Citations by year
2017: 2 · 2016: 1 · 2014: 1 · 2013: 1 · 2012: 7
FWCI
3.38
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
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
testosterone replacement therapy, androgen deficiency, evidence base, guideline recommendations, hypogonadism diagnosis, quality of evidence
MeSH terms
Aged, Aging, Androgens, Humans, Hypogonadism, Male, Testosterone, Guidelines as Topic

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