Abraham Morgentaler, MD (Chairman); Michael Zitzmann, MD (Cochairman);
Abdulmaged M. Traish, PhD (writing group);
Anthony W. Fox, MSc, MD (writing group); T. Hugh Jones, MD (writing group);
Mario Maggi, MD (writing group); Stefan Arver, MD; Antonio Aversa, MD;
Juliana C.N. Chan, MD; Adrian S. Dobs, MD; Geoffrey I. Hackett, MD;
Wayne J. Hellstrom, MD; Peter Lim, MD; Bruno Lunenfeld, MD;
George Mskhalaya, MD; Claude C. Schulman, MD; and Luiz O. Torres, MD


Abstract

To address widespread concerns regarding the medical condition of testosterone (T) deficiency (TD) (male hypogonadism) and its treatment with T therapy, an international expert consensus conference was convened in Prague, Czech Republic, on October 1, 2015. Experts included a broad range of medical specialties including urology, endocrinology, diabetology, internal medicine, and basic science research. A representative from the European Medicines Agency participated in a nonvoting capacity. Nine resolutions were debated, with unanimous approval: (1) TD is a well-established, clinically significant medical condition that negatively affects male sexuality, reproduction, general health, and quality of life; (2) symptoms and signs of TD occur as a result of low levels of T and may benefit from treatment regardless of whether there is an identified underlying etiology; (3) TD is a global public health concern; (4) T therapy for men with TD is effective, rational, and evidence based; (5) there is no T concentration threshold that reliably distinguishes those who will respond to treatment from those who will not; (6) there is no scientific basis for any age- specific recommendations against the use of T therapy in men; (7) the evidence does not support increased risks of cardiovascular events with T therapy; (8) the evidence does not support increased risk of prostate cancer with T therapy; and (9) the evidence supports a major research initiative to explore possible benefits of T therapy for cardiometabolic disease, including diabetes. These resolutions may be considered points of agreement by a broad range of experts based on the best available scientific evidence.

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