Male hypogonadism: recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024)
Bibliographic record
Abstract
INTRODUCTION: Male hypogonadism is a clinical condition combining low circulating testosterone (T) and specific signs and symptoms associated with impaired hormone production. OBJECTIVES: To provide the 5th International Consultation for Sexual Medicine consensus paper with recommendations concerning management strategies for hypogonadism. OUTCOMES: A narrative review combined with expert opinions on major topics concerning diagnosis of male hypogonadism; treatment options; T impact toward cardiovascular, metabolic, sexual, and reproductive health; and prostate cancer (PCa). METHODS: A consensus panel was held with leading Sexual Medicine experts during the 5th ICSM. Relevant English-language peer-reviewed literature was reviewed with a focus on research from but not limited to the last 10 years. The quality of each individual study was judged with Oxford levels of evidence (LOEs) criteria, but overall LOEs were not used as a systematic review was not performed. The expert panel generated recommendations based on the quality of evidence and criteria of Grading of Recommendations Assessment, Development and Evaluation. RESULTS: This manuscript reports a narrative reappraisal combined with authoritative expert opinion on the physiological role of T throughout the male aging process, with emphasis on the critical interpretation of the hypogonadal conditions associated with sexual dysfunction and male factor infertility. Likewise, particular attention was paid to relevant everyday clinical topics including cardiovascular health, metabolism and bone safety, and PCa survivorship. Clinically effective recommendations were given for 14 categories concerning hypogonadism diagnosis and 15 categories on testosterone therapy. STRENGTHS AND LIMITATIONS: The combined main strength and limitation is the narrative profile of this literature review, which was intentionally devoted to addressing the critical clinical aspects of male hypogonadism, while neither provides a systematic review nor a meta-analysis of the most updated published data. CONCLUSIONS: This manuscript discusses relevant clinical aspects and management recommendations of the 5th ICSM committee on male hypogonadism.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.031 | 0.097 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.008 |
| Bibliometrics | 0.013 | 0.007 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.006 | 0.005 |
| Research integrity | 0.011 | 0.008 |
| Insufficient payload (model declined to judge) | 0.018 | 0.007 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".