Care of Patients with Male Hypogonadism: A Joint Position Statement from the Brazilian Society of Endocrinology and Metabolism (SBEM), the Brazilian Society of Urology (SBU), and the Brazilian Association for Sexual Medicine and Health (ABEMSS).

Male hypogonadism has substantial effects on reproductive, metabolic, skeletal, and psychosocial health and is a prevalent condition in Brazil.

• Rising obesity rates, metabolic syndrome, and anabolic-androgenic steroid use have increased the frequency of functional hypogonadism in Brazil.
• Clinical practice for male hypogonadism 'remains heterogeneous and access to standardized recommendations is limited.'
• The condition affects multiple organ systems including reproductive, metabolic, skeletal, and psychosocial health.

Diagnosis of male hypogonadism requires morning total testosterone confirmation and assessment of gonadotropins.

• The document specifies 'morning total testosterone confirmation' as part of the diagnostic criteria.
• Assessment of gonadotropins is included in the diagnostic workup.
• The guidelines emphasize recognition of functional etiologies such as obesity-related hypogonadism.
• The document aims to reduce both underdiagnosis and overtreatment through standardized diagnostic criteria.

Testosterone replacement therapy is recommended for confirmed organic hypogonadism, with preferential use of long-acting intramuscular or transdermal formulations.

• The recommendation specifies 'preferential use of long-acting intramuscular or transdermal formulations.'
• Testosterone replacement therapy is indicated specifically for 'confirmed organic hypogonadism.'
• Fertility-preserving strategies including SERMs, hCG, and aromatase inhibitors are recommended when indicated.
• The statement also addresses monitoring protocols, safety considerations, and the management of adverse effects.

This is the first multidisciplinary Brazilian guideline harmonizing endocrine, urological, and sexual medicine perspectives for male hypogonadism.

• The position statement was developed jointly by the Department of Female Endocrinology, Andrology and Transgenderism (DEFAT) of SBEM, the Brazilian Society of Urology (SBU), and the Brazilian Association for Sexual Medicine and Health (ABEMSS).
• The consensus aims to 'promote consistent clinical decision-making, reduce underdiagnosis and overtreatment, and ensure safe, individualized care.'
• The recommendations are described as 'aligned with international principles and adapted to the national context.'
• The document is characterized as providing 'practical, evidence-based guidance for the evaluation and management of male hypogonadism in Brazil.'