Deciphering Options for Testosterone Replacement Therapy and Managing Withdrawal

Posted by Jesse N. Mills, MD | Apr 2024

Jesse N. Mills, MD, presented “Deciphering Options for Testosterone Replacement Therapy and Managing Withdrawal” at the 11th Urology Today conference on October 27, 2023.

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How to cite: Mills, Jesse N. “Deciphering Options for Testosterone Replacement Therapy and Managing Withdrawal.” October 2023. Accessed Apr 2024. https://grandroundsinurology.com/deciphering-options-for-testosterone-replacement-therapy-and-managing-withdrawal/

Deciphering Options for Testosterone Replacement Therapy and Managing Withdrawal – Summary

Jesse N. Mills, MD, discusses the importance of testosterone replacement therapy and presents an algorithm for determining treatment and managing withdrawal. He begins with an overview of the history of the study of testosterone, from the first recorded effects of castration to the warning against the over-prescription of testosterone therapy issued in 2015 by the FDA.

Dr. Mills discusses the AUA guidelines for testosterone replacement therapy and the lack of on-label options for treatment. He presents options for on-and-off-label testosterone replacement therapy.

Dr. Mills then presents an algorithm for determining the best treatment option for the patient, beginning by addressing male fertility concerns. He addresses questions of lab work, transference, insurance, administration, and other patient and physician concerns.

Dr. Mills concludes with the discontinuation of testosterone replacement therapy and when it is indicated. He discusses the available options for weaning patients off of testosterone, cautioning strongly against abrupt discontinuation.

About The 11th Urology Today Conference:

Presented by chair Ryan P. Terlecki, MD, FACS, the 11th Urology Today conference was designed to keep urologists, urologic oncologists, and other healthcare providers educated on the most pertinent issues in urology practices. Areas of focus included urologic oncology, men’s health and reconstruction, female urology, pediatric urology, kidney stones and related conditions, and methods of providing the best care amidst the required logistics of the business side of medicine.

For further educational activities from this conference, visit our collection page.

About The Author

Jesse N. Mills, MD

Dr. Jesse N. Mills, MD, is a clinical professor of urology at the David Geffen School of Medicine at the University of California Los Angeles (UCLA). He is division chief of andrology, director of the Men’s Clinic at UCLA, fellowship director of the UCLA male reproductive medicine and surgery program, and director of UCLA Urology Santa Monica. Dr. Mills is internationally recognized as a thought leader in male fertility, hypogonadism, erectile dysfunction, Peyronie's disease, and microsurgery. He has performed thousands of penile implants, vasectomy reversals, varicocelectomy and complex Peyronie's disease surgeries, and Xiaflex injections over the course of his career. Dr. Mills completed his medical degree at the University of Iowa Hospitals and Clinics in 2001, followed by his residency at the University of Colorado Health Science Center in 2007. He then completed his fellowship at Baylor College of Medicine in 2008 and received his medical board certification in urology from the American Board of Urology in 2010. His clinical specialties revolve around men's health and include male hormone management, sexual and ejaculatory dysfunction, male fertility, and Peyronie's disease. He is also the author of the bestselling book A Field Guide to Men's Health.

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