Male Hypogonadism

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G.R. Dohle (Chair), S. Arver, C. Bettocchi, T.H. Jones, S. Kliesch

1.INTRODUCTION

1.1.Aim

Androgens play a crucial role in the development and maintenance of male reproductive and sexual functions, body composition, erythropoiesis, muscle and bone health, and cognitive functions. Low levels of circulating androgens in utero can cause disturbances in male sexual development, resulting in congenital abnormalities of the male reproductive tract, such as testicular dysfunction, testicular maldescensus and hypospadias. Later in life, this may result in reduced male fertility, sexual dysfunction, decreased muscle formation and bone mineralisation, disturbances of fat metabolism and cognitive dysfunction and may contribute to the development of testicular tumours. Testosterone levels decrease slightly as a process of ageing; risks factors for developing adult onset hypogonadism are: obesity, chronic diseases and a poor general health. Symptomatic hypogonadal patients may benefit from testosterone treatment. This document presents the European Association of Urology (EAU) Guidelines on the diagnosis and treatment of male hypogonadism, with the aim to provide practical recommendations on how to deal with primary and secondary forms of hypogonadism, ageing-related decline in testosterone in men, as well as the treatment of testosterone deficiencies.

It must be emphasised that clinical guidelines present the best evidence available to the experts. However following guideline recommendations will not necessarily result in the best outcome. Guidelines can never replace clinical expertise when making treatment decisions for individual patients, but rather help to focus decisions - also taking personal values and preferences/individual circumstances of patients into account. Guidelines are not mandates and do not and should not purport to be a legal standard of care.

1.2.Publication history

These Guidelines are a series of revisions of the first edition of the EAU Guidelines on Male Hypogonadism published in 2012.

1.3.Available Publications

A quick reference document (Pocket Guidelines) is available, both in print and in a number of versions for mobile devices, presenting the main findings of the Male Hypogonadism Guidelines. These are abridged versions which may require consultation together with the full text versions. All available material can be viewed and downloaded for personal use at the EAU website. The EAU website also includes a selection of EAU guidelines articles as well as translations produced by national urological associations: http://www.uroweb.org/guidelines/online-guidelines/.

1.4.Panel composition

The EAU Male Hypogonadism Panel consists of a multidisciplinary group of experts, including urologists specialising in andrology and endocrinologists.

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