Testosterone Replacement Therapy in Hypogonadal Men.

All approved testosterone replacement methods can restore normal serum testosterone concentrations and relieve symptoms in most hypogonadal men when used according to recommendations.

• Restoration of normal serum testosterone concentrations is achievable across all approved delivery methods
• Symptom relief is achieved in most hypogonadal men
• Selection of method depends on patient preference with physician advice

Dose adjustment is possible with most testosterone delivery methods but may not be necessary in all hypogonadal men.

• Flexibility in dosing is a feature of most delivery methods
• Not all hypogonadal men will require dose adjustment after initiating therapy

The use of hepatotoxic androgens must be avoided in testosterone replacement therapy.

• Hepatotoxicity is identified as a specific safety concern with certain androgen formulations
• This represents a contraindication class for specific androgen types

Testosterone treatment induces reversible suppression of spermatogenesis.

• Suppression of spermatogenesis is a recognized consequence of testosterone replacement therapy
• The suppression is described as reversible
• For men desiring fertility in the near future, alternative treatments are recommended

Several alternative therapies to testosterone replacement exist for hypogonadal men who desire near-future fertility.

• Human chorionic gonadotropin (hCG) is identified as an alternative
• Selective estrogen receptor modulators (SERMs) are identified as an alternative
• Estrogen antagonists are identified as an alternative
• Aromatase inhibitors that stimulate endogenous testosterone production are identified as an alternative
• These agents work by stimulating endogenous testosterone production rather than exogenous replacement