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Testosterone supplementation: what and how to give.
1Medical Department, Evangelisches Krankenhaus Herne, Wiescherstrasse 24, 44623 Herne, Germany.
Summary
Testosterone levels naturally decline with age, leading to hypogonadism. Newer testosterone gels and injections offer more stable levels and improved symptom management compared to older methods.
Area of Science:
- Endocrinology
- Andrology
- Gerontology
Background:
- Serum testosterone gradually decreases with aging in men.
- Hypogonadal androgen levels are common in aging men.
- Age-associated testosterone deficiency necessitates improved delivery methods.
Purpose of the Study:
- To review current and emerging testosterone supplementation therapies.
- To evaluate the efficacy and safety of novel testosterone delivery systems.
- To discuss the role of testosterone in age-associated hypogonadism.
Main Methods:
- Review of epidemiological studies on testosterone decline.
- Analysis of clinical trial data for testosterone gels and injections.
- Evaluation of pharmacokinetic and safety profiles of different testosterone preparations.
Main Results:
- Oral testosterone is ineffective due to liver metabolism; intramuscular injections cause fluctuations.
- Transdermal testosterone patches offer better pharmacokinetics but have application site issues.
- New testosterone gels (e.g., Testogel) and long-acting injections (testosterone undecanoate) show promising stable levels and efficacy.
Conclusions:
- Newer testosterone formulations like gels and long-acting injections are likely to become the standard of care.
- Testosterone supplementation may benefit men with age-associated hypogonadism and related symptoms.
- Current data suggest no serious side effects, particularly concerning the prostate, with newer formulations.