Monitoring Table 8. Monitoring of men receiving testosterone therapy (continued)
7. Evaluate formulation-specific adverse effects at each visit (1⎟ ⊕): > Buccal testosterone tablets: inquire about alterations in taste and examine the gums and oral mucosa for irritation.
> Injectable testosterone esters (enanthate and cypionate): ask about fluctuations in mood or libido.
> Testosterone patches: look for skin reaction at the application site. > Testosterone gels: Advise patients to cover the application sites with a shirt and to wash the area with soap and water before having skin-to-skin contact, because testosterone gels leave a testosterone residue on the skin that can be transferred to a woman or child who might come in close contact. Serum testosterone levels are maintained when the application site is washed 4–6 h after application of the testosterone gel.
*Not approved for clinical use in the United States. Grading System
Strength of Recommendation
1 = strong Quality of Evidence ⊕⊕⊕⊕ = high ⊕⊕⊕ = moderate ⊕⊕ = low 2 = weak ⊕ = very low
Abbreviations ED, erectile dysfunction; FSH, follicle-stimulating hormone; LBM, lean body mass; LH, luteinizing hormone; MRI, magnetic resonance imaging; PSA, prostatic specific antigen; SFA, seminal fluid analysis; SHBG, sex hormone binding globulin
Source Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS, Montori VM. Testosterone therapy in adult men with androgen deficiency syndromes: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2010;95(6):2536-2559.
Disclaimer This Guideline attempts to define principles of practice that should produce high-quality patient care. It focuses on the needs of primary care practice, but also is applicable to providers at all levels. This Guideline should not be considered exclusive of other methods of care reasonably directed at obtaining the same results. The ultimate judgment concerning the propriety of any course of conduct must be made by the clinician aſter consideration of each individual patient situation. Neither IGC, the medical associations, nor the authors endorse any product or service associated with the distributor of this clinical reference tool.
Developed in cooperation with:
Shalender Bhasin Glenn R. Cunningham
Frances J. Hayes Alvin M. Matsumoto
Peter J. Snyder Ronald S. Swerdloff
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