Testosterone Deficiency Resolutions From an International Expert Consensus

hi I'm Abraham Morgan teller I'm an associate clinical professor at Harvard Medical School and Beth Israel Deaconess Medical Center and also the director and founder of Men's Health Boston I'm here to talk today about our paper that's coming out in Mayo Clinic proceedings the fundamental concepts regarding testosterone deficiency and treatment and international expert consensus resolutions what we did here is we pulled together 18 experts from four continents and 11 countries in the fields of urology andrology endocrinology diabetic internal medicine and basic science all the individuals on this panel had either extensive research or clinical experience with testosterone and we focused on nine fundamental concepts in an attempt to see if we could find consensus the meeting was held in Prague in the Czech Republic on October 1st 2015 under the aegis of the International Society for the study of the aging male and sponsored also by King's College London we invited the FDA as well as the European Medicines Agency to participate because several of these concerns that have appeared in the media and in medical literature have actually been generated by these regulatory agencies the FDA declined but the European Medicines Agency did allow a participant who participated in a non-voting capacity the meeting was organized around nine resolutions and how we organized this was that there was a presenter who presented the science to everyone at the meeting there was a discussant hoop then provided an alternative or additional views and then the resolution itself was then opened up for general discussion we had vigorous debate on the wording of each of these resolutions and in the end after having changed the wording of several of these in response to points and comments made during our discussions in the end we had unanimous on all of these the nine resolutions that we discussed ranged from the fact that testosterone deficiency is an important medical condition that affects male sexuality reproduction general health and well-being we continued on to the testosterone deficiency is a global health concern and we addressed other issues such as whether or not testosterone therapy is associated with increased risk of prostate cancer and cardiovascular disease and we concluded that it was not for either one we also looked at several controversial or topical issues such as whether one needs to have an identified etiology or cause of testosterone deficiency in order to merit treatment this is a concept that has been put forth by the FDA our group found no evidence to support this and as the cause of the symptoms and the manifestations of testosterone deficiency come from the decline in testosterone itself regardless of what the underlying etiology that may be another issue that I would just comment on here that since our time is short is the idea of having a cut point or a threshold at which point one should not treat men due to age and it was our conclusion that there was no evidence to support this that older men appeared to respond just as well to testosterone therapy as do younger men the fact that we were able to get unanimous agreement from such a broad group of experts is very important because what it speaks to is that physicians and researchers all of whom had extensive clinical and research experience with testosterone deficiency and its treatment could agree on several fundamental concepts and although one would never want to say that there are no areas of dispute within the field of course there are but these fundamental concepts including several that are controversial were not controversial for this group in addition in this article our group addresses several of the commonly raised concerns about testosterone therapy these include comments such as testosterone therapy is investigational or experimental that the symptoms do not merit treatment that the testosterone deficiency occurs is a normal part of Aging and therefore doesn't merit treatment and even that the condition of testosterone deficiency or low t doesn't exist our international panel found no evidence to support any of these concepts low testosterone is a well-established condition that has been documented in medical textbooks going on for generations testosterone therapy has risks as do all medical treatments but to call it risky I think is in unfair overall assessment and finally in terms of age that we treat a whole variety of age-related conditions in medicine including cardiovascular disease pulmonary disease diabetes hypertension poor vision poor hearing arthritis and even cancer and the idea that just because something becomes more prevalent as we get older is not by itself a reason to not treat it we found that the testosterone therapy is an important treatment for men who have the condition of testosterone deficiency speaking on behalf of this very distinguished international scientific expert consensus panel our goal here was to actually address the fundamental concepts of this field to lay down a foundation on which further research and discussions can take place we believe that by presenting the scientific evidence that to the public in to the medical community that we can move forward in a way that will help our patients and also help the research we hope you found this presentation from the content of Mayo Clinic proceedings valuable our journals mission is to promote the best interests of patients by advancing the knowledge and professionalism of the physician community if you are interested in more information about us our homepage is WWL clinic proceedings org there you will find access information for our social media content such as additional videos on our youtube channel or journal updates on Facebook you can also follow us on Twitter more information about health care at Mayo Clinic is available at WWE Oakland org this video content is copyrighted by Mayo foundation for medical education and research

Channel: Mayo Proceedings

Views: 17,965

Keywords: Testosterone, hypogonadism, testosterone therapy, Mayo Clinic Proceedings, Fundamental Concepts, Testosterone Deficiency, International Expert Consensus Resolutions

Id: tGKd3OJX_TY

Length: 7min 10sec (430 seconds)

Published: Tue Jun 21 2016