A practical guide to diagnosis, management and treatment of testosterone deficiency for Canadian physicians

  • Alvaro Morales Emeritus Professor of Urology, Director, Centre for Applied Urological Research, Queen’s University, Kingston, ON
  • Anthony J. Bella Assistant Professor of Urology, University of Ottawa, Associate Scientist in Neuroscience, Endowed Chair in Men’s Health Research, Director of Urologic Basic Science Research, Ottawa Health Research Institute, Ottawa, ON
  • Samuel Chun Lecturer, Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS
  • Jay Lee Clinical Lecturer, Department of Surgery, Division of Urology, University of Calgary, Rockyview General Hospital, Calgary, AB
  • Peter Assimakopoulos Assistant Professor, Department of Medicine, McGill University, Division of Endocrinology, Jewish General Hospital, Montréal, QC
  • Richard Bebb Clinical Assistant Professor, UBC, Endocrinologist, St Paul’s Hospital, Vancouver, BC
  • Irv Gottesman Assistant Professor, Faculty of Medicine, University of Toronto, Director, Division of Endocrinology, Credit Valley Hospital, Director, Bariatric & Metabolic Health Program, Cleveland Clinic Canada (Toronto), Toronto, ON
  • Pierre Alarie Coordinator, Unité des Dysfonctions Sexuelles, CHUM, Hôpital St-Luc, Assistant Professor, Department of Family Medicine, Université de Montréal, Co-Founder of Réseau de Médecine Sexuelle du Québec, Montréal, QC
  • Hélène Dugré Family Physician, Clinical Psychologist, Unité des Dysfonctions Sexuelles, CHUM, Hôpital St-Luc, Montreal, QC
  • Stacy Elliott Medical Director, BC Centre for Sexual Medicine, Vancouver Hospital, Medical Director, Sexual Assessment and Rehabilitation Clinic, Men’s Health Initiative, Clinical Professor, Department of Psychiatry and Urological Sciences, Faculty & Principle Investigator, International Collaboration on Repair Discoveries (ICORD), UBC, Vancouver, BC

Abstract

The percentage of men receiving appropriate management for
testosterone deficiency syndrome (TDS) is small in comparison
to prevalence estimates. This is despite linkages to cardiovascular
disease, osteoporosis, diabetes, sexual function, sarcopenia, emotional
well-being and the metabolic syndrome. Furthermore, the
availability of guidelines has not significantly enhanced the care of
TDS patients. A multidisciplinary group of medical experts sought
to improve the management of testosterone-deficient patients by
Canadian physicians. This report describes their conclusions and
defines an algorithm for appropriate TDS management.

Le pourcentage d’hommes recevant une prise en charge appropriée
pour un syndrome de carence en testostérone est faible en comparaison
avec les taux de prévalence évalués, et ce, malgré le lien
entre ce syndrome et les maladies cardiovasculaires, l’ostéoporose,
le diabète, la fonction sexuelle, la sarcopénie, le bien-être émotionnel
et le syndrome métabolique. Par ailleurs, la publication
de guides de pratique n’a pas amélioré de façon significative
les soins offerts aux patients atteints du syndrome de carence en
testostérone. Une équipe multidisciplinaire de médecins a tenté
d’améliorer la prise en charge des patients atteints de ce syndrome
par les médecins canadiens. Le présent rapport décrit leurs conclusions
et propose un algorithme de prise en charge.

Author Biographies

Alvaro Morales, Emeritus Professor of Urology, Director, Centre for Applied Urological Research, Queen’s University, Kingston, ON
Anthony J. Bella, Assistant Professor of Urology, University of Ottawa, Associate Scientist in Neuroscience, Endowed Chair in Men’s Health Research, Director of Urologic Basic Science Research, Ottawa Health Research Institute, Ottawa, ON
Samuel Chun, Lecturer, Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS
Jay Lee, Clinical Lecturer, Department of Surgery, Division of Urology, University of Calgary, Rockyview General Hospital, Calgary, AB
Peter Assimakopoulos, Assistant Professor, Department of Medicine, McGill University, Division of Endocrinology, Jewish General Hospital, Montréal, QC
Richard Bebb, Clinical Assistant Professor, UBC, Endocrinologist, St Paul’s Hospital, Vancouver, BC
Irv Gottesman, Assistant Professor, Faculty of Medicine, University of Toronto, Director, Division of Endocrinology, Credit Valley Hospital, Director, Bariatric & Metabolic Health Program, Cleveland Clinic Canada (Toronto), Toronto, ON
Pierre Alarie, Coordinator, Unité des Dysfonctions Sexuelles, CHUM, Hôpital St-Luc, Assistant Professor, Department of Family Medicine, Université de Montréal, Co-Founder of Réseau de Médecine Sexuelle du Québec, Montréal, QC
Hélène Dugré, Family Physician, Clinical Psychologist, Unité des Dysfonctions Sexuelles, CHUM, Hôpital St-Luc, Montreal, QC
Stacy Elliott, Medical Director, BC Centre for Sexual Medicine, Vancouver Hospital, Medical Director, Sexual Assessment and Rehabilitation Clinic, Men’s Health Initiative, Clinical Professor, Department of Psychiatry and Urological Sciences, Faculty & Principle Investigator, International Collaboration on Repair Discoveries (ICORD), UBC, Vancouver, BC
How to Cite
Morales, A., Bella, A. J., Chun, S., Lee, J., Assimakopoulos, P., Bebb, R., Gottesman, I., Alarie, P., Dugré, H., & Elliott, S. (1). A practical guide to diagnosis, management and treatment of testosterone deficiency for Canadian physicians. Canadian Urological Association Journal, 4(4), 269-75. https://doi.org/10.5489/cuaj.880