Related Experiment Video
Updated: Apr 19, 2026
Establishment of Rat Models Mimicking Gender-affirming Hormone Therapies
Published on: January 10, 2025
Testosterone replacement therapy: who to evaluate, what to use, how to follow, and who is at risk?
1University of Massachusetts Medical School, Worcester, MA.
Background:
Hypogonadism, defined as a low serum testosterone in the presence of signs and symptoms, is common, particularly in aging men. Testosterone supplementation therapy (TST) is the standard treatment for male hypogonadism. It has been demonstrated to have a significant impact on the signs and symptoms of hypogonadism, but there are concerns about the increase in TST and its potential adverse effects, particularly cardiovascular effects.
Objective:
This review presents health care providers with current information regarding the prevalence and impact of hypogonadism, as well as the diagnosis, evaluation, and treatment of hypogonadism. The beneficial and potential adverse effects are reviewed with a discussion on the current cardiovascular controversy.
Methods:
We reviewed current and "landmark" articles in the English-language literature pertaining to hypogonadism, its prevalence, etiologies, presentation, evaluation, and treatment.
Results:
Authorities in the field have offered guidelines and recommendations regarding the diagnosis, evaluation, and management of hypogonadism. Although there is a consensus as to the definition of hypogonadism as the presence of a low serum testosterone with signs and symptoms of hypogonadism, there is variability in the definition of "low testosterone." Various testosterone formulations exist, differing in route and frequency of administration as well as in side-effect profiles. Testosterone supplementation therapy should be continued in individuals demonstrating an improvement in signs and symptoms, which may take 3 months to a year for maximum response. Individuals treated with TST require monitoring for adverse effects. Further studies are needed to determine the impact of TST on cardiovascular health.
Conclusion:
Hypogonadism is common, particularly in aging men. Symptomatic individuals who have no contraindications to TST should be offered treatment. A careful assessment of treatment response after adequate titration and duration of therapy as well as monitoring for adverse effects is essential in treating patients for hypogonadism. Although hypogonadism is associated with increased all-cause and cardiovascular-related mortality, controversy exists regarding the impact of TST on cardiovascular risk, highlighting the need for further studies.
Insights
Male hypogonadism is common, especially in aging men. Testosterone supplementation therapy (TST) can improve symptoms, but careful monitoring for adverse effects and cardiovascular risks is essential.
Area of Science:
- Endocrinology
- Men's Health
- Geriatrics
Background:
- Hypogonadism (low testosterone with symptoms) is prevalent, particularly in aging males.
- Testosterone supplementation therapy (TST) is a standard treatment for hypogonadism.
- Concerns exist regarding increased TST use and potential cardiovascular adverse effects.
Purpose of the Study:
- To provide healthcare providers with current information on hypogonadism prevalence, diagnosis, and treatment.
- To review the beneficial and adverse effects of TST, including the cardiovascular controversy.
- To guide the evaluation and management of male hypogonadism.
Main Methods:
- Comprehensive review of current and landmark English-language literature.
- Focused on hypogonadism prevalence, etiologies, presentation, evaluation, and treatment.
- Analysis of guidelines and recommendations from field authorities.
Main Results:
- Consensus exists on defining hypogonadism (low testosterone with symptoms), but 'low testosterone' definitions vary.
- Multiple testosterone formulations are available with different administration routes and side-effect profiles.
- TST should continue for symptomatic improvement (3 months to 1 year for maximum response), with monitoring for adverse effects.
Conclusions:
- Symptomatic hypogonadism in individuals without contraindications warrants TST consideration.
- Careful assessment of treatment response and adverse effects is crucial.
- While hypogonadism is linked to mortality, TST's cardiovascular impact remains controversial, necessitating further research.
Related Concept Videos
01:29Therapeutic Drug Monitoring: Affecting Factors
01:26Testosterone: Functions and Regulation
01:20Disorders of the Male Reproductive System
Prostate disorders are another major concern. These conditions can impair urinary flow due to the prostate's location around the urethra....
01:24Drug Toxicity: Risk factors
01:16Therapeutic Drug Monitoring: Overview and Classification
01:16Insulin: Dosing Regimen and Adverse Effects
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...