Guidelines For The Management Of Testosterone Deficiency

The aim of this paper is to present to sexologists the French recommendations for the diagnosis and management of testosterone deficiency (TD). These are recommendations of good practice. They have been elaborated by the French Society of Sexual Medicine (SFMS) and the Committee of Andrology and Sexual Medicine (CAMS) of the French Association of Urology (AFU) who gathered a panel of experts. They used the method of recommendations for clinical practice (RCP). DT is defined as the combination of suggestive clinical signs and symptoms and a decrease in testosterone (T) levels in the blood. Sexual dysfunction is often the first warning sign, as T is important for all male sexual function (desire, arousal, pleasure and orgasm). The most typical symptoms are: decreased sexual desire, loss of nocturnal erections, fatigue, loss of muscle strength. Also frequently associated are: overweight, depressed mood, anxiety or irritability. DT is more frequent in patients with certain chronic diseases, in patients with a history of andrology, and in patients treated long-term with certain molecules. Biological diagnosis: it is recommended to prefer the determination of free or bioavailable T, rather than total T. Treatment of DT requires a prior clinical (digital rectal examination, breast and testicular examination) and biological (PSA, hematocrit) assessment. There are few contraindications to T treatment and few side effects. Treatment consists of long-term T supplementation and lifestyle advice. The treatment is monitored at 3, 6, 12 months and then every year. It is clinical (annual digital rectal examination) and biological (total T, PSA, CBC). (C) 2021 Sexologies. Published by Elsevier Masson SAS. All rights reserved.