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2014 ; 15
(9
): 1247-64
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An update on male hypogonadism therapy
#MMPMID24758365
Surampudi P
; Swerdloff RS
; Wang C
Expert Opin Pharmacother
2014[Jun]; 15
(9
): 1247-64
PMID24758365
show ga
INTRODUCTION: Men who have symptoms associated with persistently low serum total
testosterone level should be assessed for testosterone replacement therapy. AREAS
COVERED: Acute and chronic illnesses are associated with low serum testosterone
and these should be recognized and treated. Once the diagnosis of male
hypogonadism is made, the benefits of testosterone treatment usually outweigh the
risks. Without contraindications, the patient should be offered testosterone
replacement therapy. The options of testosterone delivery systems (injections,
transdermal patches/gels, buccal tablets, capsules and implants) have increased
in the last decade. Testosterone improves symptoms and signs of hypogonadism such
as sexual function and energy, increases bone density and lean mass and decreases
visceral adiposity. In men who desire fertility and who have secondary
hypogonadism, testosterone can be withdrawn and the patients can be placed on
gonadotropins. New modified designer androgens and selective androgen receptor
modulators have been in preclinical and clinical trials for some time. None of
these have been assessed for the treatment of male hypogonadism. EXPERT OPINION:
Despite the lack of prospective long-term data from randomized, controlled
clinical trials of testosterone treatment on prostate health and cardiovascular
disease risk, the available evidence suggests that testosterone therapy should be
offered to symptomatic hypogonadal men.
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