Diagnosis

Document Overview

Design and created by Guideline Central in participation with the Endocrine Society.

Testosterone Therapy in Men With Hypogonadism

Endocrine Society

Publication Date: Mar 17, 2018

Page Last Updated: Sep 1, 2026

Grading System

Quality of Evidence
Description of Evidence	High Quality	Moderate Quality	Low Quality	Very Low Quality
Description of Evidence	Well-performed RCTs Very strong evidence from unbiased observational studies	RCTs with some limitations Strong evidence from unbiased observational studies	RCTs with serious flaws Some evidence from observational studies	Unsystematic clinical observations Very indirect evidence from observational studies
Strength of Recommendation
Strong (1): "ES recommends..." Benefits clearly outweigh harms and burdens or vice versa	1-H	1-M	1-L	1-VL
Conditional (2): "ES suggests..." Benefits closely balanced with harms and burdens	2-H	2-M	2-L	2-VL
Ungraded Good Practice Statement		UGPS

Document Overview

Document Title: Testosterone Therapy in Men With Hypogonadism

Authoring Society: Endocrine Society

Document Publication Date: Mar 17, 2018

Page Last Reviewed/Updated: Sep 1, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: academic.oup.com/jcem/article/103/5/1715/4939465

Source Citation: Shalender Bhasin, Juan P Brito, Glenn R Cunningham, Frances J Hayes, Howard N Hodis, Alvin M Matsumoto, Peter J Snyder, Ronald S Swerdloff, Frederick C Wu, Maria A Yialamas, Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline, The Journal of Clinical Endocrinology & Metabolism, Volume 103, Issue 5, May 2018, Pages 1715–1744, https://doi.org/10.1210/jc.2018-00229

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Document Objectives: To update the “Testosterone Therapy in Men With Androgen Deficiency Syndromes” guideline published in 2010.

Scope: Management, Treatment

Diseases/Conditions (MeSH)

D013739 - Testosterone

D007006 - Hypogonadism

D000728 - Androgens

D013739 - Testosterone

D007006 - Hypogonadism

D000728 - Androgens

Keywords: Androgen Deficiency Syndromes, low testosterone, male hypogonadism, testosterone

Target Patient Population: Men With Hypogonadism

Inclusion Criteria: Male, Adult, Older Adult

Health Care Settings: Ambulatory

Intended Users: Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Number of Source Documents: 156

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: Yes

Testosterone Therapy in Men With Hypogonadism

Diagnosis

Diagnosis of Hypogonadism in Men

Diagnosis of Men with Suspected Hypogonadism

Screening and Case Detection for Hypogonadism

Distinguishing Between Primary or Secondary Hypogonadism

Evaluation for Determining the Etiology of Hypogonadism

Treatment

Treatment of Hypogonadism with Testosterone

Older Men with Age-Related Decline in Testosterone Concentration

HIV-Infected Men with Weight Loss

Men with Type 2 Diabetes Mellitus

Grading System

Document Overview

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Recommendation Development Processes & Methodology