algorithm for diagnosing and managing testosterone deficiency (TD) in an adult man

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Adapted from Minhas and Mulhall, 2017.1 Copyright © British Society for Sexual Medicine. December 2017.

TT - total testosterone, LH - luteinizing hormone, FSH - follicle stimulating hormone, SHBG - sex-hormonebinding globulin, FT - free testosterone, CV - cardiovascular, CVD - cardiovascular disease, T Therapy -testosterone therapy, HCG -human chorionic gonadotropin, SERMs - selective oestrogen receptor modulators, AIs - aromatase inhibitors, PSA - prostate specific antigen,

*For men with TT levels <5.2nmol/L plus low LH and FSH or increased prolactin levels, refer to endocrinology or arrange a pituitary MRI to exclude a pituitary adenoma3,6

**These drugs should not be used if pituitary function is compromised. SERMs and aromatase inhibitors are not currently licensed for TD


Last edited 06/2018 and last reviewed 11/2018