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Multidisciplinary Insights Into the Assessment, Diagnosis, and Management of Hypogonadism


This activity was developed for endocrinologists, urologists, primary care clinicians, and other health care professionals who treat patients with hypogonadism.


Other obstacles clinicians must overcome include therapy selection, monitoring, and adherence. Goals for treatment are to restore serum testosterone levels to normal and to alleviate signs and symptoms associated with low testosterone. This paper will address these clinical challenges and provide insight into various multidisciplinary approaches to the assessment, diagnosis, and management of patients with hypogonadism.

Hypogonadism is a clinical condition in which low levels of serum testosterone are associated with myriad signs and symptoms, including diminished libido and sense of vitality, and erectile dysfunction. It is a highly prevalent condition that affects 4 to 5 million men in the United States, yet it is often unrecognized, underdiagnosed, and undertreated. Reasons for this deficiency include a lack of awareness among clinicians, time constraints in everyday practice, and a lack of established ranges for laboratory parameters.

Diagnosis of hypogonadism can be challenging. It is important for clinicians to recognize that hypogonadism is a condition comprising many signs and symptoms and is not solely dependent on a decreased level of testosterone. Patient history, general health, lifestyle, and testosterone levels should be considered in the diagnosis for hypogonadism. Diagnosing hypogonadism is complicated by several issues, including constellation of signs and symptoms, lack of concrete testosterone thresholds, and wide variability in assays and laboratory measurements. Comorbid conditions, such as type 2 diabetes, obesity, metabolic syndrome, and cardiovascular disease, can affect or be affected by testosterone levels.


At the completion of the activity, participants should be better able to:

  • Discuss the complex characteristics of hypogonadism and describe how it can manifest as a cluster of nonspecific signs and symptoms

  • Identify hypogonadism when a man presents with comorbid conditions, such as erectile dysfunction, depression, or loss of energy

  • Determine treatment goals for patients based on clinical presentation and laboratory parameters

  • Review the options available to treat hypogonadism and provide clinical recommendations on how to initiate and monitor testosterone therapy, including baseline assessment, medical history, and laboratory value analysis

  • Utilize a multidisciplinary approach to treating hypogonadism and associated conditions by making appropriate referrals to specialists when necessary


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