When should I consider referring a patient for specialist assessment of male hypogonadism?

Consider referring a patient for specialist assessment of male hypogonadism if:

• There is a suspicion of hypogonadism based on low serum testosterone levels or abnormalities in related hormones such as follicle-stimulating hormone (FSH), luteinizing hormone (LH), or prolactin.
• Testosterone replacement therapy is being considered, as specialist input is important for diagnosis confirmation and management.
• The patient presents with erectile dysfunction and hypogonadism is suspected, warranting endocrinology referral.

Specialist assessment may include detailed hormonal evaluation and consideration of testosterone replacement therapy, which can improve sexual function and responsiveness to other treatments in men with confirmed androgen deficiency.

Referral to endocrinology is recommended following initial assessment in primary care when hypogonadism is suspected or confirmed, to guide appropriate management and monitoring.

This approach aligns with recommendations from the British Society for Sexual Medicine (BSSM) and European Association of Urology (EAU) guidelines.

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