From the Guidelines
A urologist who specializes in endocrinology issues related to testosterone and erectile dysfunction is called an andrologist. Andrologists are urologists with additional training in male reproductive health and hormonal disorders, as suggested by the American College of Physicians guideline on hormonal testing and pharmacologic treatment of erectile dysfunction 1. They are uniquely qualified to address both the urological and endocrinological aspects of conditions like low testosterone (hypogonadism) and erectile dysfunction. These specialists can perform comprehensive evaluations including:
- Hormone level testing
- Physical examinations
- Specialized diagnostic procedures to determine the underlying causes of these conditions. They can prescribe appropriate treatments ranging from testosterone replacement therapy (which may include injections, gels, patches, or pellets) to medications for erectile dysfunction such as PDE5 inhibitors (sildenafil, tadalafil, vardenafil, avanafil), as discussed in the guideline 1. Andrologists can also address the complex interplay between hormonal imbalances and sexual function, providing more targeted care than seeing separate specialists. To find an andrologist, you can search for urologists who specifically list andrology or male reproductive health as their subspecialty, or ask your primary care physician for a referral to a urologist with expertise in hormonal disorders. It is essential to note that the prevalence of low testosterone varies from 12.5% to 36% in studies of men with ED, and the evidence is inconclusive about the effectiveness of hormonal treatment in the management of patients with ED, even in patients with low testosterone levels, as stated in the guideline 1. However, andrologists are best equipped to individualize decisions to measure hormone levels on the basis of the clinical presentation and physical findings that suggest hormonal abnormality.