Table 4. Recommendations – initiating T Therapy.

Criteria for appropriate initiation of testosterone therapy	LoE	Grade
Perform cardiovascular, prostate, breast and haematological assessment before the start of treatment	1a	A
TT level <12 nmol/L or FT <225 pmol/L (<0.225 nmol/L) (based on two separate 8–11 am levels), usually requires T Therapy [1].	1	A
TT level >12 nmol/L, or FT of >225 pmol/L (>0.225 nmol/L), does not require T Therapy [1].	1	A
Evidence supports the treatment of men with TT levels <14 nmol/L in symptomatic men with pre-diabetes to prevent progression to overt type 2 diabetes [53].	2	B
Offer T Therapy to symptomatic men with TD syndrome for treated localised low risk prostate cancera and without evidence of active disease (based on measurable PSA, DRE and evidence of metastatic disease)	3	B
Assess cardiovascular risk factors commencing T Therapy and optimise secondary prevention in men with established disease	1a	A

T Therapy: testosterone therapy, TT: total testosterone, FT: free testosterone, TD: testosterone deficiency, PSA: prostate specific antigen, DRE: digital rectal examination.

^a<8 Gleason score, stage 1–2, pre-op PSA <10 ng/mL and not starting before 1 year of follow-up.