Testosterone treatment to mimic hormone physiology in androgen replacement therapy

Abstract

There is still considerable controversy concerning the issue of testosterone replacement therapy. This is because testosterone replacement therapy is not a ‘risk-free’ treatment and a randomized controlled trial to evaluate safety of prolonged testosterone replacement therapy is not available, nor is it likely to be in the near future. However, recent testosterone delivery systems, such as the 1% gel (Testogel^®, Androgel^® and Testim^®), have proven to have a good physiologic profile, allowing constant monitoring of the possible complications and prompt discontinuation in the event of adverse effects. The aim of this paper is to provide a comprehensive review of the available testosterone preparations to treat male hypogonadism, with special interest in the treatment of ageing men and late-onset hypogonadism. In addition, the experimental and clinical data on the effect of testosterone on sexual function domains is reviewed along with the indication for the combination therapy of androgens with pro-erectile drugs, for example, type 5 phosphodiesterase inhibitors.

Keywords::

• ageing
• androgen replacement therapy
• erectile dysfunction
• hypogonadism
• testosterone

Acknowledgements

This work was supported by a governmental research grant from the PRIN-MIUR (Progetti Ricerca Interesse Nazionale 2005, MIUR). The authors have no conflict of interest to declare and no fee has been received for preparation of the manuscript.