Testosterone Replacement Therapy in Hypogonadal Men

Endocrinol Metab Clin North Am. 2022 Mar;51(1):77-98. doi: 10.1016/j.ecl.2021.11.005. Epub 2022 Feb 8.

Abstract

All approved testosterone replacement methods, when used according to recommendations, can restore normal serum testosterone concentrations, and relieve symptoms in most hypogonadal men. Selection of the method depends on the patient's preference with advice from the physician. Dose adjustment is possible with most delivery methods but may not be necessary in all hypogonadal men. The use of hepatotoxic androgens must be avoided. Testosterone treatment induces reversible suppression of spermatogenesis; if fertility is desired in the near future, human chronic gonadotropin, selective estrogen receptor modulator, estrogen antagonist, or an aromatase inhibitor that stimulates endogenous testosterone production may be used.

Keywords: Endogenous testosterone stimulators; Implants; Intramuscular injections; Modified androgens; Oral capsules; Selective androgen receptor modulators; Transdermal gels.

Publication types

  • Review

MeSH terms

  • Androgens / therapeutic use
  • Hormone Replacement Therapy
  • Humans
  • Hypogonadism* / drug therapy
  • Male
  • Spermatogenesis
  • Testosterone / adverse effects

Substances

  • Androgens
  • Testosterone