Guidelines
Diagnosis and management of testosterone deficiency syndrome in men: clinical practice guideline
Alvaro Morales, Richard A. Bebb, Priya Manjoo, Peter Assimakopoulos, John Axler, Christine Collier, Stacy Elliott, Larry Goldenberg, Irv Gottesman, Ethan D. Grober, Gordon H. Guyatt, Daniel T. Holmes, Jay C. Lee and Canadian Men’s Health Foundation Multidisciplinary Guidelines Task Force on Testosterone Deficiency
CMAJ December 08, 2015 187 (18) 1369-1377; DOI: https://doi.org/10.1503/cmaj.150033
Alvaro Morales
Department of Urology (Morales), Queen’s University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen’s University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men’s Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women’s College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
CM MDRichard A. Bebb
Department of Urology (Morales), Queen’s University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen’s University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men’s Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women’s College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
MDPriya Manjoo
Department of Urology (Morales), Queen’s University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen’s University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men’s Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women’s College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
MD MScPeter Assimakopoulos
Department of Urology (Morales), Queen’s University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen’s University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men’s Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women’s College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
MDJohn Axler
Department of Urology (Morales), Queen’s University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen’s University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men’s Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women’s College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
MDChristine Collier
Department of Urology (Morales), Queen’s University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen’s University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men’s Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women’s College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
PhDStacy Elliott
Department of Urology (Morales), Queen’s University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen’s University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men’s Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women’s College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
MDLarry Goldenberg
Department of Urology (Morales), Queen’s University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen’s University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men’s Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women’s College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
CM OBC MDIrv Gottesman
Department of Urology (Morales), Queen’s University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen’s University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men’s Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women’s College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
MDEthan D. Grober
Department of Urology (Morales), Queen’s University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen’s University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men’s Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women’s College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
MD MEdGordon H. Guyatt
Department of Urology (Morales), Queen’s University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen’s University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men’s Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women’s College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
MD MScDaniel T. Holmes
Department of Urology (Morales), Queen’s University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen’s University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men’s Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women’s College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
MDJay C. Lee
Department of Urology (Morales), Queen’s University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen’s University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men’s Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women’s College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
MDDepartment of Urology (Morales), Queen’s University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen’s University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men’s Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women’s College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul’s Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
Data supplements
Online Appendix
Podcast
To request a transcript of this podcast, contact cmajgroup{at}cmaj.ca.
Related Articles
- Hackett, G. I. (2015). Controversies in the diagnosis and management of testosterone deficiency syndrome. CMAJ, 187(18), 1342-1344. Accessed August 14, 2024. https://doi.org/10.1503/cmaj.151208.
- (2015). Highlights. CMAJ, 187(18), 1335. Accessed August 14, 2024. Retrieved from http://www.cmaj.ca/content/187/18/1335.
In this issue
Article tools
Diagnosis and management of testosterone deficiency syndrome in men: clinical practice guideline
Alvaro Morales, Richard A. Bebb, Priya Manjoo, Peter Assimakopoulos, John Axler, Christine Collier, Stacy Elliott, Larry Goldenberg, Irv Gottesman, Ethan D. Grober, Gordon H. Guyatt, Daniel T. Holmes, Jay C. Lee, Canadian Men’s Health Foundation Multidisciplinary Guidelines Task Force on Testosterone Deficiency
CMAJ Dec 2015, 187 (18) 1369-1377; DOI: 10.1503/cmaj.150033
Diagnosis and management of testosterone deficiency syndrome in men: clinical practice guideline
Alvaro Morales, Richard A. Bebb, Priya Manjoo, Peter Assimakopoulos, John Axler, Christine Collier, Stacy Elliott, Larry Goldenberg, Irv Gottesman, Ethan D. Grober, Gordon H. Guyatt, Daniel T. Holmes, Jay C. Lee, Canadian Men’s Health Foundation Multidisciplinary Guidelines Task Force on Testosterone Deficiency
CMAJ Dec 2015, 187 (18) 1369-1377; DOI: 10.1503/cmaj.150033
Jump to section
Related Articles
Cited By...
- Does my patient have testosterone deficiency?
- Male hypogonadism: a review
- Testosterone therapy in hypogonadal men: a systematic review and network meta-analysis
- Testosterone use causing erythrocytosis
- Predicting low testosterone in aging men: a systematic review
- Controversies in the diagnosis and management of testosterone deficiency syndrome
Podcast