Expert Opinion on the Diagnosis and Management of Male Hypogonadism in India.

Male hypogonadism (MH) is a clinical and biochemical syndrome caused by inadequate synthesis of testosterone. Untreated MH can result in long-term effects, including metabolic, musculoskeletal, mood-related, and reproductive dysfunction. Among Indian men above 40 years of age, the prevalence of MH is 20%-29%. Among men with type 2 diabetes mellitus, 20.7% are found to have hypogonadism. However, due to suboptimal patient-physician communication, MH remains heavily underdiagnosed. For patients with confirmed hypogonadism (either primary or secondary testicular failure), testosterone replacement therapy (TRT) is recommended. Although various formulations exist, optimal TRT remains a considerable challenge as patients often need individually tailored therapeutic strategies. Other challenges include the absence of standardized guidelines on MH for the Indian population, inadequate physician education on MH diagnosis and referral to endocrinologists, and a lack of patient awareness of the long-term effects of MH in relation to comorbidities. Five nationwide advisory board meetings were convened to garner expert opinions on diagnosis, investigations, and available treatment options for MH, as well as the need for a person-centered approach. Experts' opinions have been formulated into a consensus document with the aim of improving the screening, diagnosis, and therapy of men living with hypogonadism.

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Copyright © 2023 Sanjay Kalra et al.

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SK has received speaker fees from Abbott. JJ has received research grant and speaker fees from Novo Nordisk, Sanofi-Syntholab, and Biocon, speaker fees from Astra Zeneca and Boehringer Ingelheim, and consulting fees from Abbott and USV. AGK has received research grant and speaker fees/honoraria from Sanofi, Novo Nordisk, Abbott, Lilly, Boehringer Ingelheim, AstraZeneca, and Servier, and is an advisory board member of Sanofi, Novo Nordisk, Abbott, and Boehringer Ingelheim. RS has received speaker fees from Novo Nordisk, USV, Torrent Pharmaceuticals, and Intas Pharma and is an advisory board member of Torrent Pharmaceuticals. MT has received speaker fees/honoraria from Astra Zeneca, Novo Nordisk, BI, Lupin, Abbott India, and USV and is an advisory board member of Johnson and Johnson, Boehringer Ingelheim, Novo Nordisk, and Abbott. GB, AS, SJ, MSA NK, BS, and KK have no conflicts of interest to declare.