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Abraham Morgentaler, Guideline for Male Testosterone Therapy: A Clinician’s Perspective, The Journal of Clinical Endocrinology & Metabolism, Volume 92, Issue 2, 1 February 2007, Pages 416–417, https://doi.org/10.1210/jc.2006-2629
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Given the amount and complexity of new information regarding androgen deficiency and its treatment, The Endocrine Society’s Clinical Practice Guidelines (1) (“the Guidelines”) are a welcome addition to the literature, representing the consensus recommendations of some of the most thoughtful “greybeards” in the field. However, the absence of large-scale clinical testosterone trials leaves room for alternative approaches, and I am grateful for the opportunity to share my views as a urologist specializing in the treatment of male sexual dysfunction.
During my training, I had been taught that androgen deficiency was rare and testosterone treatment ineffective. I was therefore surprised, when I began my practice in 1988, to discover that low levels of total and free testosterone were frequently associated with erectile dysfunction (ED), and testosterone injections regularly improved erections. I was further gratified when patients thanked me for making them “feel normal again.” When patients complained that their symptoms recurred 10–14 d after their last testosterone injection, coinciding with the anticipated testosterone nadir, I became convinced this was not a placebo effect and that men could determine when their testosterone levels were low.
