The DOI matches its Crossref record; 140 of the 146 references it cites were found in a registry or an index.
Why Is Androgen Replacement in Males Controversial?
Abstract
Context: Symptoms and signs consistent with androgen deficiency and low testosterone levels are recognized frequently in clinical practice. Recent population-based epidemiological studies indicate that low testosterone levels in men are associated with increased morbidity and mortality. The clinician must be able to counsel patients to help them determine whether testosterone replacement therapy is appropriate for them. Evidence Acquisition: The authors have conducted a literature search in PubMed, and we have reviewed references in the multiple systematic reviews and meta-analyses that have been published on this topic. Evidence Synthesis: We have attempted to provide the reader with an appreciation of the evidence that can be used to support the diagnosis of androgen deficiency, the efficacy of treatment, the potential risks of treatment, the therapeutic options, and the recommendations for monitoring treatment. Conclusions: We think that published clinical experience justifies testosterone replacement therapy in males who have not initiated puberty by age 14 and in males with low testosterone levels due to classical diseases of the hypothalamic-pituitary-gonadal axis. The benefit:risk ratio is less certain in older men and in those with chronic diseases associated with low testosterone levels. The decision to treat in this setting is much more controversial because there are few large clinical trials that have demonstrated efficacy and no large clinical trials that have determined potential risks of increasing the incidence of clinical prostate cancers or cardiovascular events. We provide a critical review of the evidence that supports treatment and potential risks and ways to reduce the risks if the physician and patient elect testosterone replacement.
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In the citing paper
“a verdict can only be reached with large-scale studies including 5000 men over 5 years (95)”
From Onset of effects of testosterone treatment and time span until maximum effects are achieved (2011) · cites this paper as [95]
In the citing paper
“It is still hotly debated whether this is a true form of hypogonadism, or a decline of serum testosterone associated with the progressive accumulation of health problems with aging (95, 96), but rather independently of the process of aging itself.”
From Onset of effects of testosterone treatment and time span until maximum effects are achieved (2011) · cites this paper as [95]
Citations
Cites
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Heart Disease and Stroke Statistics—2009 Update
WRITING GROUP MEMBERS, Lloyd‐Jones, D. M., Adams, R. J., Carnethon, M. R., SIMONE, G. D., Ferguson, T. B., Flegal, K. M., Ford, E. S., Furie, K. L., Go, A. S., et al. (2009) · Circulation · doi:10.1161/circulationaha.108.191259 · Cited by 3,915
A Critical Evaluation of Simple Methods for the Estimation of Free Testosterone in Serum
Vermeulen, A., Verdonck, L., & Kaufman, J. M. (1999) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.84.10.6079 · Cited by 3,824
WRITING GROUP MEMBERS, Lloyd-Jones, D., Adams, R., Carnethon, M., De Simone, G., Ferguson, T. B., Flegal, K., Ford, E., Furie, K., Go, A., et al. (2009) · Circulation · doi:10.1161/circulationaha.108.191261 · Cited by 3,140
Longitudinal Effects of Aging on Serum Total and Free Testosterone Levels in Healthy Men
Harman, S. M., Metter, E. J., Tobin, J. D., Pearson, J., & Blackman, M. R. (2001) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.86.2.7219 · Cited by 2,760
The Development of Human Benign Prostatic Hyperplasia with Age
Berry, S. J., Coffey, D. S., Walsh, P. C., & EWING, L. L. (1984) · The Journal of Urology · doi:10.1016/s0022-5347(17)49698-4 · Cited by 2,491
Bhasin, S., Cunningham, G. R., Hayes, F. J., Matsumoto, A. M., Snyder, P. J., Swerdloff, R. S., & Montori, V. M. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-2354 · Cited by 1,954
Self-citationFeldman, H. A., Longcope, C., Derby, C. A., Johannes, C. B., Araujo, A. B., Coviello, A. D., Bremner, W. J., & McKinlay, J. B. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.87.2.8201 · Cited by 1,861
Identification of late-onset hypogonadism in middle-aged and elderly men
Wu, F. C. W., Tajar, A., Beynon, J. M., Pye, S. R., Silman, A. J., Finn, J. D., O'Neill, T. W., Bartfai, G., Casanueva, F. F., Forti, G., et al. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa0911101 · Cited by 1,544
Adverse Events Associated with Testosterone Administration
Basaria, S., Coviello, A. D., Travison, T. G., Storer, T. W., Farwell, W. R., Jette, A. M., Eder, R., Tennstedt, S., Ulloor, J., Zhang, A., et al. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa1000485 · Cited by 1,494
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Items 101–111 of 111
Plasma Testosterone and Dihydrotestosterone as Markers of Heart Disease and Mortality in Older Men
Yeap, B. B. (2015) · Springer eBooks · doi:10.1007/978-94-007-7741-5_38-1
Review Article Andropause: Current concepts
Singh, P. (2013)
Risques prostatiques de la testostérone : nouveau retour du balancier?
Buvat, J. (2012) · Basic and Clinical Andrology · doi:10.1007/s12610-012-0171-6
Terapi Sulih Hormon Testosterone Pada Lansia
Sihombing, B., Ariestine, D. A., Purba, A. S., & Memorison, T. (2016)
Khan, S. D. (2016) · Springer eBooks · doi:10.1007/978-81-322-3604-7_13
(2011) · Current Opinion in Endocrinology Diabetes and Obesity · doi:10.1097/med.0b013e32834decbe
Mulhall, J. P., Stahl, P. J., & Stember, D. S. (2013) · Springer eBooks · doi:10.1007/978-1-4614-6693-2_12
Kavoussi, P. K., & Machen, G. L. (2023) · Cambridge University Press eBooks · doi:10.1017/9781009197533.033
Testosteron und kardiovaskuläre Effekte
Yeap, B. B. (2024) · Springer eBooks · doi:10.1007/978-3-031-65245-5_19
Choi, D., Hong, J. H., Lee, G., Kim, J., & Choi, C. (2026) · Medicina · doi:10.3390/medicina62071334
Kemp, T. (2014) · UpSpace Institutional Repository (University of Pretoria)
Metadata
- Authors
- Cunningham, G. R., & Toma, S. M.
- Affiliations
- Baylor St. Luke's Medical Center (US)
- Corresponding author
- Cunningham, Glenn R.
- ORCID
- Cunningham, Glenn R.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2011-01-01
- Volume
- 96
- Issue
- 1
- Pages
- 38-52
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2129345748
- Cited by
- 111
- References
- 146
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 3 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 1 · 2018: 2 · 2017: 4 · 2016: 10 · 2015: 11 · 2014: 17 · 2013: 23 · 2012: 17
- FWCI
- 2.37
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- testosterone replacement therapy, male hypogonadism, androgen deficiency, risk-benefit assessment, prostate cancer risk, cardiovascular risk, hypothalamic-pituitary-gonadal axis, treatment monitoring, older men, chronic disease
- MeSH terms
- Androgens, Humans, Hypogonadism, Male, Hormone Replacement Therapy
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