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Cited by 96Hormonal and reproductive studiesMenopause: Health Impacts and TreatmentsAdrenal Hormones and Disorders

Testosterone replacement therapy: for whom, when and how?

Tsametis, Christos P., Isidori, Andrea M.·2018·Metabolism
DOI 10.1016/j.metabol.2018.03.007
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Abstract

The finding of low circulating testosterone level in men is relatively frequent. The symptoms of hypogonadism are very frequent in the aging men. However, the diagnosis of hypogonadism is often neglected and the opportunity to replace low testosterone in older men is highly debated. The aim of this narrative review is to summarize the steps necessary to formulate a proper diagnosis and to guide toward an individualized treatment. While universally recognized the need to treat the young adults with known causes of pituitary or testicular failure, there are controversies on the cost-benefit of treating testosterone deficiency in older men. Discrepancies among the several available guidelines do not help to clarify the scenario, however, the recent larger clinical trials have shed some light on the fact that testosterone treatment carries some benefit, that is not free from risks. We provide an updated review of the diagnostic hallmarks, the several treatment modalities, with their advantages and disadvantages, and how to individualize and monitor treatment in order to maximize the benefits and minimize the risks. The treatment of male hypogonadism can no longer be downgraded and must become part of the cultural baggage of the endocrinologist.

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Authors
Tsametis, C. P., & Isidori, A. M.
Affiliations
  • Aristotle University of Thessaloniki (GR)
  • Sapienza University of Rome (IT)
Corresponding author
Tsametis, Christos P.
ORCID
Isidori, Andrea M.
Venue
Metabolism
Publisher
Elsevier BV
Published
2018-09
Volume
86
Pages
69-78
ISSN
0026-0495 (ISSN-L)
DOI
10.1016/j.metabol.2018.03.007
OpenAlex
W2789489125
Cited by
96
References
113
Citations by year
2026: 5 · 2025: 14 · 2024: 10 · 2023: 8 · 2022: 18 · 2021: 20 · 2020: 10 · 2019: 10 · 2018: 1
FWCI
1.58
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Metabolism (publishedVersion)
  • PubMed (publishedVersion)
  • IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
testosterone replacement therapy, male hypogonadism, androgen deficiency, older men, hypogonadism diagnosis, personalized treatment, treatment monitoring, treatment risks and benefits, cost-benefit analysis, clinical guidelines, clinical trials
MeSH terms
Age Factors, Diagnostic Techniques, Endocrine, Drug Administration Schedule, Humans, Hypogonadism, Male, Testosterone, Time Factors, Patient Selection, Hormone Replacement Therapy, Early Diagnosis, Time-to-Treatment

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