Target Audience

This educational initiative is intended to provide continuing medical education to primary care physicians (PCPs) and other health care professionals involved in the diagnosis and long-term management of male hypogonadism (MHG).

Statement of Need/Program Overview

MHG is a common endocrine syndrome characterized by pathologically low levels of testosterone.1 An estimated 6% to 9.5% of men 40 to 70 years old have MHG, although the condition can present in men of any age.2,3 Low testosterone levels have significant consequences for men. Symptoms include sexual dysfunction, depressed mood, cognitive deficits, reduced muscle mass, and even increased mortality.4-7 Additionally, MHG has been linked to several comorbidities, including obesity, diabetes, hypertension, and dyslipidemia, among others.1 Variability in clinical presentations contributes to underdiagnosis and undertreatment of MHG in the United States.8 Traditionally managed in urology practices, MHG is increasingly being identified and treated in primary care.9 Clinicians must be prepared to perform a thorough physical exam, obtain a targeted patient history, and order appropriately timed laboratory tests. Thus, primary care clinicians will benefit from practical evidence-based recommendations for MHG diagnosis and management with the goal of improving outcomes for patients with MHG.

References

  1. Dandona P, Rosenberg MT. A practical guide to male hypogonadism in the primary care setting. Int J Clin Pract. 2010;64:682-696.
  2. Araujo AB, Esche GR, Kupelian V, et al. Prevalence of symptomatic androgen deficiency in men. J Clin Endocrinol Metab. 2007;92:4241-4247.
  3. Tostain JL, Blanc F. Testosterone deficiency: a common, unrecognized syndrome. Nat Clin Pract Urol. 2008;5:388-396.
  4. Barrett-Connor E, Von Muhlen DG, Kritz-Silverstein D. Bioavailable testosterone and depressed mood in older men: the Rancho Bernardo Study. J Clin Endocrinol Metab. 1999;84:573-577.
  5. Matsumoto AM. Fundamental aspects of hypogonadism in the aging male. Rev Urol. 2003;5(suppl 1):S3-S10.
  6. Bhasin S, Cunningham GR, Hayes FJ, et al. Testosterone therapy in adult men with androgen deficiency syndromes: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2006;91:1995-2010.
  7. Araujo AB, Dixon JM, Suarez EA, et al. Clinical review: Endogenous testosterone and mortality in men: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2011;96:3007-3019.
  8. Mulligan T, Frick MF, Zuraw QC, Stemhagen A, McWhirter C. Prevalence of hypogonadism in males aged at least 45 years: the HIM study. Int J Clin Pract. 2006;60:762-769.
  9. Jockenhovel F. Testosterone therapy--what, when and to whom? Aging Male. 2004;7:319-324.

Educational Objectives

After completing this activity, the participant should be better able to:

  • Diagnose MHG based on the full spectrum of patient symptoms and laboratory testing results
  • Evaluate patients for potential risks and benefits related to testosterone replacement therapy for MHG
  • Construct treatment regimens for patients with MHG that reflect the patient’s medical history, disease etiology, and comorbidities

Faculty

Steven A. Kaplan, MD
E. Darracott Vaughan Jr. Professor of Urology
Chief, Institute for Bladder and Prostate Health
Weill Cornell Medical College
Director, Iris Cantor Men’s Health Center
New York-Presbyterian Hospital
Weill Cornell Medical Center
New York, New York

Physician Accreditation Statement

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 Global Education Group (Global) and Integritas Communications. Global is accredited by the ACCME to provide continuing medical education for physicians.

Physician Credit Designation

Global Education Group designates this live activity for a maximum of 0.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Global Contact Information

For information about the accreditation of this program, please contact Global at 303-395-1782 or inquire@globaleducationgroup.com.

Instructions to Receive Credit

Participants will have two attempts to obtain a passing grade of 70% on the posttest and be eligible to obtain CME credit. In order to receive credit for this activity, the participant must complete the Global Education Group program evaluation form.

Fee Information& Refund/Cancellation Policy

There is no fee for this educational activity.

Disclosure of Conflicts of Interest

Global Education Group (Global) requires instructors, planners, managers, and other individuals and their spouse/life partner who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by Global for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

The faculty reported the following financial relationships or relationships to products or devices they or their spouses/life partners have with commercial interests related to the content of this CME activity:

  • Steven A. Kaplan, MD
    Consultant/ Independent Contractor: Merck; Grant/Research Support: Pfizer

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouses/life partners have with commercial interests related to the content of this CME activity:

  • Ashley Marostica, RN, MSN Nothing to disclose
  • Amanda Glazar, PhD Nothing to disclose
  • Jim Kappler, PhD Nothing to disclose

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Global Education Group (Global) and Integritas Communications do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

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