ENDO 2018 Panel Updates Testosterone Therapy Treatment Guidelines

Written by Dr. White, Published on April 9th, 2018

The Endocrine Society is the leading authority on Hormonal Disorders in the world. At this year’s ENDO 2018 medical conference, clinical guidelines for Testosterone Replacement Therapy were released to the public. As you likely know, there is a range of opinions regarding the proper use of Bio-Identical Testosterone for Low-T. These clinical guidelines are intended to be a broad outline of the potential array of applications for Testosterone Therapy. Individual Endocrinologists and Hormone Specialists are still urged to use their best personal judgment, and these guidelines are intended to help them provide treatment accurately and specifically to the individuals that need it most.

2017 was a big year for Testosterone Research, and this year’s presentation reflected that fact. Major Clinical Trials were completed and fully analyzed. Researchers streamlined the mechanisms of Testosterone Deficiency Diagnosis and more. This is the first time that Low-T Guidelines have been adjusted since 2010. As Testosterone Therapy becomes more widely accepted, you can imagine that men are more interested than ever in the treatment.

How Do We Determine Who Can Benefit from Low-T Therapy Most?

The leader of the Low-T Guidelines Task Force is Shalender Bhasim, a doctor at the Brigham and Women’s Hospital. He explains that these updated guidelines are necessary because the number of HRT Clinics that offer Testosterone Therapy has ballooned in the last decade. Surveys have shown that many men that are prescribed Testosterone are not sufficiently tested or monitored while taking the treatments. This means that many men get Testosterone without a clear clinical need and that many patients are at increased risk of medical complications resulting from inadequate monitoring.

The problem extends in both directions, however. While many men without Hypogonadism are getting treatment that they don’t need, lots of men aren’t screened for Low-T that may benefit significantly from the regimen. It’s essential, in the interest of public health, that Testosterone Replacement Therapy is adequately and accurately diagnosed and treated.

Who Should Be Screened for Low-T?

Dr. Bhasim does not recommend widespread screening for Testosterone Deficiency, however. Though Low-T is relatively common, patients don’t need to undergo Hypogonadism Testing unless they show clear signs of deficiency, including fatigue, low libido, weight gain, loss of strength, and depression. In the future, it will very likely be reasonable to provide Testosterone to asymptomatic patients with Low Testosterone, but there is not enough published research to support that option at this time.

Like Human Growth Hormone Deficiency and other Hormonal Disorders, Low-T is a broad spectrum disorder, and every patient reacts to declining Testosterone Levels based on their unique physiology. Every patient should get individualized treatment that caters to their personal needs. The decision to adopt a Low-T Therapy Program should be the result of the doctor’s recommendation and the patient’s conclusion that the benefits outweigh the risks.

Who Will Benefit Most from Testosterone Replacement Therapy?

With this vast increase in available medical data, the Low-T Task Force has been able to define who can benefit from Testosterone Therapy and why more confidently. They recommend Testosterone Replacement for two broad groups: for those with extreme Hypogonadism and those with Testosterone Deficiency. For patients with significant Hypogonadism, Testosterone Creams, Patches, and Injections can help maintain secondary sex characteristics such as body composition, auxiliary hair distribution, and sexual function.

For men struggling with Andropause or otherwise dealing with Testosterone Suppression, Bio-Identical Testosterone can increase sex drive as well as the ability to achieve an erection and derive pleasure from sexual activity. Evidence also shows that Testosterone Treatments can improve bone mineral density in the hips and spine, as well as treat anemia in many patients.

Should Men Over 65 Take Testosterone?

While Testosterone Replacement can be beneficial for males older than 65, it should be approached with caution. It should only be prescribed to those with abundantly clear signs of Testosterone Deficiency, and should only be offered after conferring closely with the patient.

The Effect of Opiates on Testosterone Levels

A significant point of emphasis for Dr. Bhasim and his colleagues was the frequency with which Testosterone Therapy was prescribed as a result of Low-T caused by the use of prescription opiates. This condition is known as Opiate-Induced Androgen Deficiency (OPIAD). Opioids have a dramatic effect on Testosterone Levels, leading to significant deficiency as quickly as a week after treatment begins. It’s estimated that 20% of Low-T Patients are treated as a result of OPIAD. For this reason, it is entirely essential that a patient’s medical history with Opiates and Steroids be made clear to the prescribing Hormone Doctor.

Updated Risks of Low-T Therapy

One of the central concerns of the panel was how Testosterone Treatments affected Red Blood Cell Count. Bio-Identical Testosterone Therapy tends to increase RBC Count, which can potentially be problematic for some patients. As of now, there is no substantial evidence that Low-T Therapy increases the risk of prostate cancer, nor does it indicate a higher risk of heart attack, stroke, and other dangerous heart anomalies.

Should You Choose Testosterone?

In the end, you’ll be expected to make the final decision regarding whether Testosterone is right for you. Don’t be nervous about asking your doctor any question that you may have. Only choose a reputable Hormone Clinic that offers thorough testing of your Testosterone Levels. While there are risks to Testosterone Replacement Therapy, these risks are significantly reduced as long as your therapy follows widely agreed-upon guidelines. If you’re interested in a quality Testosterone Therapy Regimen, we encourage you to contact us for a free consultation!

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