9
Table 4. Conditions in Which T Administration Is Associated
With a High Risk of Adverse Outcomes and for
Which We Recommend Against Using T
Very high risk of serious adverse outcomes
• Metastatic prostate cancer
• Breast cancer
Moderate to high risk of adverse outcomes
• Unevaluated prostate nodule or induration
• Unevaluated prostate-specific antigen (PSA) >4 ng/mL (>3 ng/mL in
individuals at high risk for prostate cancer, such as African Americans or
men with first-degree relatives who have prostate cancer)
• Hematocrit >48% (>50% for men living at high altitude)
• Severe lower urinary tract symptoms (LUTS) associated with benign
prostatic hypertrophy as indicated by America Urological Association
(AUA)/ International Prostate Symptom Score (IPSS) >19
• Uncontrolled or poorly controlled congestive heart failure
• Desire for fertility in the near term
Adapted with permission from Bhasin et al. J Clin Endocrinol Metab. 2010;95(6):
2536–2559.
HIV-Infected Men with Weight Loss
➤ ES suggests that clinicians consider short-term testosterone therapy
in HIV-infected men with low testosterone concentrations and weight
loss (when other causes of weight loss have been excluded) to induce
and maintain body weight and lean mass gain. (2|⊕⊕
)
Men with Type 2 Diabetes Mellitus
➤ In men with type 2 diabetes mellitus who have low testosterone
concentrations, ES recommends against testosterone therapy as a
means of improving glycemic control. (1|⊕⊕
)
