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Low Testosterone Medscape CME Expert Column Series. Issue 1: Testosterone Deficiency in Men: Common and Under-recognized

  • Authors: Martin M. Miner, MD
  • CME Released: 8/5/2011
  • Valid for credit through: 8/5/2012
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Target Audience and Goal Statement

This activity was developed for primary care physicians, nurse practitioners (NPs), and physician assistants (PAs).

Testosterone replacement therapy (TRT) is a topic of debate because of incomplete knowledge of the clinical entity of testosterone deficiency (TD), also known as hypogonadism. Sexual symptoms such as decreased libido and impaired sexual performance can markedly impair quality of life, and most patients with TD come to the attention of clinicians when they present with erectile dysfunction. However, recent studies that demonstrate a clear association of TD with serious comorbidities, especially cardiovascular disease, metabolic syndrome, and diabetes mellitus, mandate that clinicians improve their knowledge of the condition, laboratory and clinical workup, and available treatment options.

Treatment of TD is complicated by the lack of consensus on a definition. National and international guidelines are fairly consistent in their recognition of the signs and symptoms of TD, but biochemical parameters vary widely. Serum total testosterone is the most widely used measurement for establishing TD, but the cutoff levels that define biochemical TD vary from 200 to 300 ng/dL. Furthermore, the point at which biochemical parameters and the clinical picture merit TRT remains in flux.

TD was once considered a disorder to be treated by specialists such as urologists or endocrinologists. However, as the role of primary care has expanded, generalist physicians as well as NPs and PAs are likely to be the first healthcare providers to see men with the clinical syndrome of TD and should maintain a high index of suspicion in such patients.

The goals of this program are to improve recognition of TD, better understand the importance of associated comorbidities, and describe varying definitions of TD that confound prevalence estimates.

Upon completion of this activity, participants should be able to:

  1. Describe consistencies and disparities in definitions of TD in men.
  2. Summarize key findings on the prevalence of TD.
  3. Discuss leading comorbidities associated with TD, including diabetes and metabolic syndrome.


No off-label uses of any agent are discussed.

All activity faculty and planners participating in continuing medical education activities sponsored by New York Medical College are expected to disclose to the audience any significant support or substantial relationship(s) with providers of commercial products and/or devices discussed in this activity and/or with any commercial supporters of the activity. In addition, all faculty are expected to openly disclose any off-label, experimental, or investigational use of drugs or devices discussed in this activity. The faculty and planning committee have been advised that this activity must be free from commercial bias, and based upon all the available scientifically rigorous data from research that conforms to accepted standards of experimental design, data collection, and analysis.


  • Martin M. Miner, MD

    Clinical Associate Professor of Family Medicine and Urology, The Warren Alpert Medical School of Brown University, Co-director, Men’s Health Center, Chief of Family and Community Medicine, The Miriam Hospital, Providence, Rhode Island


    Disclosure: consultant: Abbott Laboratories, Endo Pharmaceuticals; consultant/researcher: Auxilium Pharmaceuticals Inc; researcher: GlaxoSmithKline.


The Planning Committee for this activity included Kathy Kavanagh, Director, and Margaret Astrologo, Assistant Director of New York Medical College; and Ruth Cohen, CCMEP, Vice President, CME Director, and Margaret Inman, Senior Editor of Continuing Education Alliance. The members of the Planning Committee have no significant relationships to disclose.

Accreditation Statements

    For Physicians

  • This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council For Continuing Medical Education (ACCME) through the joint sponsorship of New York Medical College (NYMC) and Continuing Education Alliance. NYMC is accredited by the ACCME to provide continuing medical education for physicians.

    New York Medical College designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Contact This Provider

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit, you must receive a minimum score of 70% on the post-test.

Follow these steps to earn CME/CE credit*:

  1. Read the target audience, learning objectives, and author disclosures.
  2. Study the educational content online or printed out.
  3. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. In addition, you must complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates by accessing "Edit Your Profile" at the top of your Medscape homepage.

*The credit that you receive is based on your user profile.


Low Testosterone Medscape CME Expert Column Series. Issue 1: Testosterone Deficiency in Men: Common and Under-recognized

Authors: Martin M. Miner, MDFaculty and Disclosures

CME Released: 8/5/2011

Valid for credit through: 8/5/2012


This content is no longer available.

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