NEEDS ASSESSMENT

Over the last two decades there has been a growing awareness of the impact of testosterone deficiency (TD), also called hypogonadism, on men’s health. Though the condition of TD was once associated primarily with obvious and severe medical conditions, today we recognize that TD affects a large number of otherwise healthy adults, and is particularly prevalent among men with common chronic medical conditions such as diabetes, obesity, and chronic pulmonary disease. Another emerging concept is that TD affects much more than sexuality. TD has been shown to be associated with impaired mood, sense of vitality, diminished energy, chronic fatigue, loss of muscle mass, truncal obesity, the metabolic syndrome, and osteoporosis.

Although many of the issues associated with TD relate to general medicine, the urologist has an important role in the diagnosis and treatment of TD. Since the sexual symptoms are often the presenting symptoms that drive the patient to seek medical attention, the urologist is often the first person with an opportunity to diagnose the condition. As the specialist most closely involved with male-specific health issues, it is important for the urologist to become familiar with current evidence regarding the impact of TD on men’s health. In this issue, authors will review the various signs and symptoms of TD, who is a candidate for treatment, considerations in choosing forms of testosterone therapy, the risks of treatment, and how to monitor the man receiving testosterone therapy.