Original Articles
Diagnosis and management of testosterone deficiency syndrome in men: clinical practice guideline
Alvaro Morales, Richard A. Bebb, Priya Manjoo, Peter Assimakopoulos, John Axler, Christine Collier, Stacy Elliott, Larry Goldenberg, Irv Gottesman, Ethan D. Grober, Gordon H. Guyatt, Daniel T. Holmes, Jay C. Lee and Canadian Men's Health Foundation Multidisciplinary Guidelines Task Force on Testosterone Deficiency
CMAJ October 26, 2015 cmaj.150033; DOI: https://doi.org/10.1503/cmaj.150033
Alvaro Morales
Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
Richard A. Bebb
Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
Priya Manjoo
Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
Peter Assimakopoulos
Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
John Axler
Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
Christine Collier
Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
Stacy Elliott
Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
Larry Goldenberg
Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
Irv Gottesman
Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
Ethan D. Grober
Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
Gordon H. Guyatt
Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
Daniel T. Holmes
Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
Jay C. Lee
Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
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