Don't Prescribe 'T' Without 'E'

Bradley D. Anawalt, MD


April 01, 2014

In This Article

Practice Pearls

In summary, clinicians should avoid ordering testosterone measurements for men who are at low likelihood of having male hypogonadism. Specifically, clinicians should be cautious about ordering testosterone measurements in younger overweight men who feel that they are not as muscular as they should be or in middle-aged to older men who simply do not "feel right" and want to feel younger.

When the clinician suspects a diagnosis of male hypogonadism, measurement of serum testosterone should be performed on a blood sample drawn in the early morning hours. A low testosterone level should be confirmed at least once, also on a blood sample drawn between 7 AM and 10 AM.

Clinicians must exercise prudence in the initial assessment of male hypogonadism to avoid unnecessary expense, inconvenience, and possible adverse effects in men for whom the benefit of testosterone therapy is unclear. For men with true male hypogonadism, the benefits outweigh the potential risks associated with testosterone therapy, but for many overweight sedentary men, a healthy lifestyle with regular exercise and reduced caloric intake is the wiser choice.


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