1. The male menopause 0r The new treatment for type 2 diabetes? Dr Colin Johnston WHHT

2. Symptoms of Testosterone deficiency Diminished energy Diminished libido Erectile dysfunction Decreased muscle mass Increased fat mass-central Sleep disturbance

3. Symptoms of the ageing process Diminished energy Diminished libido Erectile dysfunction Decreased muscle mass Increased fat mass-central Sleep disturbance

5. Assessment of Testosterone deficiency Testosterone-9am SHBG-Free T. index Albumin-CBT If low or borderline-LH,FSH, Prolactin, FT4/TSH Age matched-’normal range’

6. Treatment evidence free-zone Benefits-symptoms Risks-prostate, polycythaemia

7. What should we do Treat if diagnosis confirmed (CBT< 4, high LH,) Reassure the obviously normal ?trial of Rx for others

8. Monitoring Well-being and behaviour Testosterone levels PSA fbc

9. Treatment options Gels Depot injections

10. No long-term evaluation

11. Testosterone, insulin resistance and type 2 diabetes

13. What should we do Check testosterone-certainly in all those with ED and diabetes Lifestyle advise ? Trial of Rx-Some evidence of benefit