Novel androgen therapies including nasal testosterone, aromatase inhibitors, selective oestrogen receptor modulators, and selective androgen receptor modulators have been developed to treat male hypogonadism while mitigating the recognised side effects of conventional testosterone replacement therapy.
Key Findings
Background
Male hypogonadism is associated with reduced quality of life and development of co-morbidities including obesity, diabetes mellitus, and dyslipidaemia.
The condition is linked to multiple metabolic co-morbidities including obesity, diabetes mellitus, and dyslipidaemia.
Hypogonadism is associated with reduced quality of life.
The mainstay of treatment remains testosterone replacement therapy (TRT).
Background
Testosterone replacement therapy (TRT) has recognised side effects that limit its use in certain patient populations.
TRT is associated with impaired spermatogenesis, limiting its use in men wishing to preserve fertility.
There are concerns regarding the use of TRT in men with concurrent cardiovascular disease.
These side effects have created an impetus to develop novel androgen therapies.
Results
Nasal testosterone has been developed as a novel delivery method for treating male hypogonadism.
Nasal testosterone is discussed as one of the novel androgen therapies reviewed.
It represents an alternative delivery route compared to conventional TRT formulations.
Nasal delivery may offer a different side effect profile compared to traditional TRT.
Results
Aromatase inhibitors and selective oestrogen receptor modulators (SERMs) represent alternative pharmacological approaches to treating male hypogonadism.
Aromatase inhibitors and SERMs are reviewed as novel therapies for male hypogonadism.
These agents work through modulation of the hypothalamic-pituitary-gonadal axis rather than direct testosterone replacement.
Their use may avoid some of the side effects associated with exogenous testosterone administration, including effects on spermatogenesis.
Results
Selective androgen receptor modulators (SARMs) are discussed as a novel therapeutic class for male hypogonadism.
SARMs are highlighted as a distinct class of novel androgen therapies.
They are designed to selectively target androgen receptors with the aim of achieving tissue-specific effects.
SARMs represent an approach intended to provide benefits of androgen therapy while mitigating recognised side effects of TRT.
Kang J, Chen R, Tharakan T, Minhas S. (2022). Novel androgen therapies including selective androgen receptor modulators.. Best practice & research. Clinical endocrinology & metabolism. https://doi.org/10.1016/j.beem.2022.101686