This is a very interesting article not dealing directly with anesthesia however I think it is important for our readers and providers to have this knowledge.
By Kelly Young
Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD
The American College of Physicians suggests that clinicians discuss whether to start testosterone therapy with men who have age-related low testosterone and want to treat their sexual dysfunction, according to new guidelines published in the Annals of Internal Medicine.
The guidelines were based on 38 randomized controlled trials. Among the other recommendations:
- Testosterone is not recommended for other nonspecific symptoms of aging, like fatigue or cognitive decline.
- For men treated with testosterone, clinicians should schedule follow-up for 12 months later and occasionally thereafter. Treatment should be discontinued in men with no improvement in sexual function.
- Clinicians should consider intramuscular injection over transdermal application because of lower costs.
An editorialist says this last recommendation “will be questioned by many clinicians.” He notes: “The lower cost of intramuscular preparations ($156 vs. $2135 annually) is a major consideration. But the need for an intramuscular injection every 1 to 4 weeks is a potential barrier to adherence, and some patients require visits to a health care facility for the injections, which may add to the expense.”