Purpose of review 

The incidence of testosterone deficiency and number of men on testosterone therapy (TTh) has increased significantly over the past 3 decades. This rise has been accompanied by controversies surrounding the indications and possible adverse effects of therapy. To better inform prescribing habits among providers, many major medical associations have devised guidelines regarding the diagnosis and management of testosterone deficiency. While these guidelines agree in many areas, there are some key differences that should be identified. This review will explore the similarities, differences, and rationale for these guidelines.

Recent findings 

Over the past 7 years, much attention has been devoted to the implications of TTh on cardiac health. All reviewed guidelines include dedicated sections discussing these implications and the society's position on prescribing testosterone considering recent findings, however, differ on specific contraindications to TTh and when to initiate therapy after a cardiovascular event. In addition, the American College of Physicians released its first guideline earlier this year which may impact prescribing habits among primary care physicians.

Summary 

The differences between testosterone deficiency guidelines may indicate gaps in our knowledge of testosterone deficiency and focuses of future research efforts. Prescribers should be aware of these differences and discuss all treatment options with their patients.

中文翻译：

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睾丸激素疗法：最新指南在哪里达成共识并有所不同？

审查目的 

在过去的30年中，睾丸激素缺乏症的发生率和接受睾丸激素治疗（TTh）的男性人数显着增加。这种上升伴随着围绕适应症和治疗可能产生的不良影响的争议。为了更好地告知提供者之间的开药习惯，许多大型医学协会已经制定了有关睾丸激素缺乏症诊断和治疗的指南。尽管这些准则在许多领域都达成了共识，但仍应确定一些关键差异。这篇评论将探讨这些准则的相似性，差异和理由。

最近的发现 

在过去的7年中，TTh对心脏健康的影响已引起了很多关注。所有经过审查的指南都包括专门的部分，讨论这些影响以及社会考虑最近的发现而在开具睾丸激素的立场，但是在TTH的特定禁忌症和心血管事件后何时开始治疗方面有所不同。此外，美国内科医师学会于今年早些时候发布了第一条指南，这可能会影响初级保健医师的处方习惯。

概要 

睾丸激素缺乏症指南之间的差异可能表明我们对睾丸激素缺乏症的认识存在差距，并且是未来研究工作的重点。处方者应意识到这些差异，并与患者讨论所有治疗方案。