Low testosterone affects 4 to 5 million men over the age of 39 and is associated with a multitude of symptoms including loss of libido and sexual function, decreased energy, increased body fat, osteoporosis, reduced muscle mass, and loss of body hair. A decline in testosterone level is a normal part of aging and is not a problem in itself; however, in a significant percentage of men, this decline has been found to be associated with life-threatening chronic conditions including diabetes mellitus, cardiovascular disease, and metabolic syndrome. With a prevalence of this scale, screening consideration by the primary care practitioner is essential. This activity uses an interactive, case-based format, to help improve the diagnosis, management, and treatment of this condition and aims to ultimately improve the quality of life of men with low testosterone.

The goal of this activity is to address the knowledge gaps of primary care practitioners and provide current information on the diagnosis, management, and treatment of male hypogonadism.

This activity has been designed for primary care practitioners who manage and treat men who have, or who are at risk for, hypogonadism. No prerequisites required.

At the conclusion of this educational activity, the participants should be able to:

• STATE the prevalence of male hypogonadism in the general male population and in those with associated comorbid conditions.
• IDENTIFY three health-related risk factors and/or comorbid conditions associated with male hypogonadism.
• ANALYZE the role of testosterone replacement therapy in improving the health and quality of life of men with hypogonadism.

The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.

The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Johns Hopkins University School of Medicine designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

After participating in this online activity, participants may receive credit by completing the CME test, evaluation, and receiving a score of 70% or higher.

The estimated time to complete this activity: 90 minutes.

Release date: November 15, 2011. Expiration date: November 15, 2012.

METHOD OF PARTICIPATION
The following interactive case activities consist of 3 sections: a pre-test, 2 interactive cases with decision points, and a Continuing Medical Education (CME) post-test with an evaluation. All components must be completed in order to receive CME credit. A CME certificate will be available online immediately following successful completion of the module.

As a provider approved by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of the Johns Hopkins University School of Medicine Office of Continuing Medical Education (OCME) to require signed disclosure of the existence of financial relationships with industry from any individual in a position to control the content of a CME activity sponsored by OCME. Members of the Planning Committee are required to disclose all relationships regardless of their relevance to the content of the activity. Faculty are required to disclose only those relationships that are relevant to their specific presentation. The following relationships have been reported for this activity:

Course Director/Planner
Adrian S. Dobs, MD, MHS
Professor of Medicine and Oncology
Vice Chair, Department of Medicine
Faculty Development
Johns Hopkins University School of Medicine
Baltimore, Maryland

Participating Faculty
Anne R. Cappola, MD, ScM (Planner)
Assistant Professor of Medicine
Department of Medicine
Division of Endocrinology, Diabetes, and Metabolism
University of Pennsylvania
Philadelphia, Pennsylvania

Participating Speaker Disclosures
No speaker has indicated that they have any financial interests or relationships with a commercial entity whose products or services are relevant to the content of their presentation(s).

Planner Disclosures
Dr Dobs reports serving as a principal investigator for the National Institutes of Health, serving as a co-investigator for Takeda Pharmaceutical Company Limited, and serving as an advisory board member for Lilly USA, LLC.

No other planners have indicated that they have any financial interests or relationships with a commercial entity.

Grants to investigators at The Johns Hopkins University are negotiated and administered by the institution that receives the grants, typically through the Office of Research Administration. Individual investigators who participate in the sponsored project(s) are not directly compensated by the sponsor, but may receive salary or other support from the institution to support their effort on the project(s).

No faculty member has indicated that their presentation will include information on off-label products.

The opinions and recommendations expressed by faculty and other experts whose input is included in this activity are their own. This activity is produced for educational purposes only. Use of Johns Hopkins University School of Medicine name implies review of educational format, design, and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects before administering pharmacologic therapy to patients.

The Office of Continuing Medical Education (CME) at the Johns Hopkins University School of Medicine is committed to protect the privacy of its members and customers. Johns Hopkins University SOM CME maintains its Internet site as an information resource and service for physicians, other health professionals, and the public. Continuing Medical Education at the Johns Hopkins University School of Medicine will keep your personal and credit information confidential when you participate in a CME Internet based activity. Your information will never be given to anyone outside of the Johns Hopkins University School of Medicine’s CME activity. CME collects only the information necessary to provide you with the services that you request.

I certify that I am participating in this Johns Hopkins University School of Medicine activity for CME-accredited training and/or educational purposes.

I understand that while I am participating in this capacity, I may be exposed to "protected health information," as that term is defined and used in Johns Hopkins policies and in the federal HIPAA privacy regulations (the "Privacy Regulations"). Protected health information is information about a person’s health or treatment that identifies the person. I also understand that while I am participating in this capacity I will be treated as a temporary member of Johns Hopkins for purposes of the Privacy Regulations only.

I pledge and agree to use and disclose any of this protected health information only for the training and/or educational purposes of my visit and to keep the information confidential.

I understand that I may direct to the Johns Hopkins Privacy Officer any questions I have about my obligations under this Confidentiality Pledge or under any of the Hopkins policies and procedures and applicable laws and regulations related to confidentiality. The contact information is: Johns Hopkins Privacy Officer, telephone: 410-735-6509, e-mail: HIPAA@jhmi.edu.

“The Office of Continuing Medical Education at the Johns Hopkins University School of Medicine, as sponsor of this activity, has relayed information with the CME attendees/participants and certify that the visitor is here for training, education and/or observation purposes only.”

Johns Hopkins University School of Medicine
Office of Continuing Medical Education
720 Rutland Avenue/Turner 20
Baltimore, Maryland 21205-2195
Reviewed & Approved by: General Counsel, Johns Hopkins Medicine (4/1/09)

Pentium 800 processor or greater, Windows 98/NT/200/XP or Mac OS 9/X or later, Microsoft Internet Explorer, Safari, Firefox, Windows Media Player 9.0 or later Flash player, 128 MB of RAM Monitor settings: High color at 800 x 600 pixels, Sound card and speakers, Adobe Acrobat Reader.

Instructions
The following is an interactive educational case module that consists of 3 sections: an unaccredited pre-test, an interactive case study, and a CME post-test. All 3 sections must be completed to receive CME credit. A certificate of participation will be available online immediately following successful completion of the module.

Pre-Assessment

75-Year-Old Man; Chief Complaints Are Erectile Dysfunction and Lack of Energy
Anne R. Cappola, MD, ScM

48-Year-Old Man; Diagnosed at 18 with 18 Klinefelter’s Syndrome
Adrian S. Dobs, MD, MHS

Post-Assessent