Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review Article
  • Published:

Comparison of American Urological Association and Endocrine Society guidelines on testosterone replacement

International Journal of Impotence Research volume 34, pages 626–629 (2022)Cite this article

Subjects

Abstract

Low testosterone affects an increasing number of patients each year resulting in a steady increase in prescriptions for testosterone replacement therapy (TRT). In 2018, the American Urological Association (AUA) and the Endocrine Society (ES) published their guidelines for treating patients with low testosterone. While the two guidelines are similar, significant differences exist. In this review, we compare and analyze the AUA and ES guidelines in terms of diagnosis and definition, workup, monitoring of side effects, treatment outcomes for TRT, and how these guidelines are applied in our practice.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Diagnostic Flowchart.

Similar content being viewed by others

References

  1. Mulhall J, Trost L, Brannigan R, Kurtz E, Redmon J, Chiles K, et al. Evaluation and management of testosterone deficiency: AUA guideline. J Urol. 2018;200:423–32.

    Article  PubMed  Google Scholar 

  2. Bhasin S, Brito J, Cunningham G, Hayes F, Hodis H, Matsumoto A, et al. Testosterone therapy in men with hypogonadism: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103:1715–44.

    Article  PubMed  Google Scholar 

  3. Seftel A. Male hypogonadism. Part I: epidemiology of hypogonadism. Int J Impot Res. 2006;18:115–20.

    Article  CAS  PubMed  Google Scholar 

  4. Muncey W, Omil-Lima D, Jesse E, Gupta K, El Shafei A, Heflick C, et al. Assessment of public interest and current trends in testosterone replacement therapy. Int J Impot Res. 2021. [Epub ahead of print].

  5. Layton J, Kim Y, Alexander G, Emery S. Association between direct-to-consumer advertising and testosterone testing and initiation in the United States, 2009-2013. JAMA. 2017;317:1159.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Wang Y, Gay G, Botelho J, Caudill S, Vesper H. Total testosterone quantitative measurement in serum by LC-MS/MS. Clin Chim Acta. 2014;436:263–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Buvat J. Hyperprolactinemia and sexual function in men: a short review. Int J Impot Res. 2003;15:373–7.

    Article  CAS  PubMed  Google Scholar 

  8. Majumdar A, Mangal N. Hyperprolactinemia. J Hum Reprod Sci. 2013;6:168–75.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Ohlander S, Varghese B, Pastuszak A. Erythrocytosis following testosterone therapy. Sex Med Rev. 2018;6:77–85.

    Article  PubMed  Google Scholar 

  10. Gagnon D, Zhang T, Brand F, Kannel W. Hematocrit and the risk of cardiovascular disease–the Framingham study: a 34-year follow-up. Am Heart J. 1994;127:674–82.

    Article  CAS  PubMed  Google Scholar 

  11. Carter H, Albertsen P, Barry M, Etzioni R, Freedland S, Greene K, et al. Early detection of prostate cancer: AUA guideline. J Urol. 2013;190:419–26.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Ilic D, Djulbegovic M, Jung J, Hwang E, Zhou Q, Cleves A, et al. Prostate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis. BMJ. 2018;5:362.

    Google Scholar 

  13. Mulligan T, Frick M, Zuraw Q, Stemhagen A, Mcwhirter C. Prevalence of hypogonadism in males aged at least 45 years: the HIM study. Int J Clin Pract. 2006;60:762–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA

    Isaac Jake Zucker

  2. Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA

    Thomas A. Masterson

  3. Department of Urology, Bruce W. Carter VA Medical Center, Miami, FL, USA

    Thomas A. Masterson

Authors
  1. Isaac Jake Zucker
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thomas A. Masterson
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

IJZ and TAM both contributed to the crafting, drafting, and editing of the manuscript. TAM conceived and designed the manuscript.

Corresponding author

Correspondence to Thomas A. Masterson.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zucker, I.J., Masterson, T.A. Comparison of American Urological Association and Endocrine Society guidelines on testosterone replacement. Int J Impot Res 34, 626–629 (2022). https://doi.org/10.1038/s41443-021-00477-w

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41443-021-00477-w

This article is cited by

Search

Advanced search

Quick links