Table 7. Recommendations – benefits and risks of T Therapy.

Benefits and risks of testosterone therapy in men with testosterone deficiency	LoE	Grade
Beyond 6 months there is evidence of benefit for T Therapy in body composition, bone mineralisation and features of metabolic syndrome	3	A
Testosterone Therapy improves sexual desire, erectile function and sexual satisfaction	1	A
A reduction in BMI, waist size, improved glycaemic control and lipid profile are observed in hypogonadal men receiving T Therapy	2	A
Trials of T Therapy should be at least 6 months and maximal benefit is often seen beyond 12 months	2	A
Fully inform the patient about expected benefits and side-effects of therapy and facilitate a joint decision by an informed patient and physician	3	A
Fully discuss the adverse impact of T Therapy and its reversibility for future fertility and offer alternative treatment as necessary	1b	B
In patients with adult-onset TD, when T Therapy is prescribed, offer additional weight loss and lifestyle advice as standard management	2	A
In severely symptomatic patients with TT levels below 8 nmol/L, lifestyle and dietary advice alone is unlikely to produce meaningful clinical improvement within a relevant clinical period	2	B

T Therapy: testosterone therapy, BMI: body mass index, TD: testosterone deficiency, TT: total testosterone.