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Testosterone replacement therapy: For whom, when and how?

Christos P Tsametis1, Andrea M Isidori2

  • 1Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Metabolism: Clinical and Experimental
|March 14, 2018
PubMed
Summary
This summary is machine-generated.

Low testosterone (hypogonadism) is common in aging men but often overlooked. This review clarifies diagnosis and treatment, balancing benefits and risks for individualized care.

Keywords:
Adverse effectsLate-onset hypogonadismPrimary hypogonadismSecondary hypogonadismTestosterone preparationsTestosterone replacement therapy

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Area of Science:

  • Endocrinology
  • Andrology
  • Men's Health

Background:

  • Low circulating testosterone levels and hypogonadism symptoms are frequent in aging men.
  • Diagnosis of hypogonadism is often neglected, and testosterone replacement therapy (TRT) in older men is debated.
  • Existing guidelines offer conflicting advice, complicating clinical decisions.

Purpose of the Study:

  • To provide a comprehensive overview of diagnosing and treating male hypogonadism.
  • To guide clinicians toward individualized TRT strategies, considering benefits and risks.
  • To address controversies surrounding TRT in older men.

Main Methods:

  • Narrative review of diagnostic criteria for hypogonadism.
  • Analysis of current testosterone replacement therapy modalities, including advantages and disadvantages.
  • Evaluation of recent clinical trial data on TRT efficacy and safety.

Main Results:

  • Testosterone treatment offers benefits but is associated with risks, necessitating careful patient selection.
  • Individualized treatment plans are crucial for maximizing benefits and minimizing adverse effects.
  • Recent trials provide evidence supporting TRT in select older men.

Conclusions:

  • Proper diagnosis and individualized treatment of male hypogonadism are essential.
  • TRT decisions in older men require a thorough assessment of cost-benefit and risk profiles.
  • Endocrinologists must integrate comprehensive knowledge of male hypogonadism management into their practice.