Editorial

Hypogonadism in Primary Care: The Lowdown on Low Testosterone

Authors: Jacqueline Gentry, BS, Debra Jane Price, DO, Alan N. Peiris MD, PhD

Abstract

Television programming is rife with direct pharmaceutical advertisements to consumers. In the last few years, advertisements aimed at men have indicated that a low testosterone level may be responsible for fatigue and decreased well-being. These commercials stress the need for additional testing by touting the benefits of a testosterone-replete state. As the amount of advertising has risen, clinicians have seen an increase in the number of men requesting such testing. In some instances, individuals insist on testosterone replacement without definitive documentation of a hypogonadal state. Providers need to be aware that testosterone is a controlled substance. Many patients present initially to primary care, providing multiple challenges to cost-effective management.

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References

1. Pantalone KM, Faiman C. Male hypogonadism: more than just a low testosterone. Cleve Clin J Med. 2012; 79: 717–725.
 
2. Peiris AN, Sothmann MS, Aiman EJ, et al. The relationship of insulin to sex hormone-binding globulin: role of adiposity. Fertil Steril. 1989; 52: 69–72.
 
3. Amini Lari M, Parsa N, Marzban M, et al. Depression, Testosterone concentration, sexual dysfunction and methadone use among men with hypogonadism and HIV infection. AIDS Behav. 2012; 16: 2236–2243.
 
4. Bhasin S, Cunningham GR, Hayes FJ, et al. Testosterone therapy in men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2010; 95: 2536–2559.
 
5. Luboshitzky R, Aviv A, Hefetz A, et al. Decreased pituitary-gonadal secretion in men with obstructive sleep apnea. J Clin Endocrinol Metab. 2002; 87: 3394–3398.