Men with androgen deficiency require careful assessment of symptoms and signs as well as investigation to confirm the diagnosis and identify the underlying causes. Testosterone therapy will benefit men who are hypogonadal because of pituitary or testicular disease.
- Men with androgen deficiency can present with a broad range of symptoms including lethargy, decreased energy, low mood, low libido, osteopenia, reduced muscle mass and increased fat mass.
- Careful clinical assessment is required, including assessment of testicular volumes.
- Confirmatory biochemical testing is via early morning, fasting serum testosterone levels measured using an accurate assay, with sex hormone-binding globulin, luteinising hormone and follicle stimulating hormone levels providing additional information.
- Testosterone therapy is available on the PBS for men with androgen deficiency due to an established pituitary or testicular disorder.
- The patient’s desire for fertility and their cardiovascular and prostate risks should be assessed before commencing testosterone therapy.