BACKGROUND: The aim of testosterone replacement therapy (TRT) is to improve symptoms and signs of testosterone deficiency including decreased libido, erectile dysfunction, depressed mood, anaemia, loss of muscle and bone mass, by increasing serum testosterone levels to physiologic range. TRT has been used in the last 70 years, and overtime, numerous preparations and formulations have been developed to improve pharmacokinetics (PKs) and patient compliance. The routes of delivery approved for use in the Western world include buccal, nasal, subdermal, transdermal and intramuscular (IM). OBJECTIVES: The aim of this narrative review was to describe and compare all available and approved testosterone preparations according to pharmacology, PKs and adverse effects. MATERIALS AND METHODS: We have performed an extensive PubMed review of the literature on TRT in clinical practice. Contraindications and monitoring of TRT were analyzed by comparing available guidelines released in the last five years. We provide a review of advantages and disadvantages of different modalities of TRT and how to monitor treatment to minimize the risks. RESULTS: TRT is associated with multiple benefits highly relevant to the patient. However, the recommendations given in different guidelines on TRT are based on data from a limited number of randomized controlled trials (RCTs), as well as non-randomized clinical studies and observational studies. This is the case for the safety of a long-term TRT in late-onset hypogonadism (LOH). No evidence is provided indeed on the effects of TRT on endpoints such as deterioration of heart failure suggesting a cautious approach to T replacement in older men with a history of heart failure. CONCLUSION: Clinicians must consider the unique characteristics of each patient and make the necessary adjustments in the management of LOH in order to provide the safest and most beneficial results.
BACKGROUND: The aim of testosterone replacement therapy (TRT) is to improve symptoms and signs of testosterone deficiency including decreased libido, erectile dysfunction, depressed mood, anaemia, loss of muscle and bone mass, by increasing serum testosterone levels to physiologic range. TRT has been used in the last 70 years, and overtime, numerous preparations and formulations have been developed to improve pharmacokinetics (PKs) and patient compliance. The routes of delivery approved for use in the Western world include buccal, nasal, subdermal, transdermal and intramuscular (IM). OBJECTIVES: The aim of this narrative review was to describe and compare all available and approved testosterone preparations according to pharmacology, PKs and adverse effects. MATERIALS AND METHODS: We have performed an extensive PubMed review of the literature on TRT in clinical practice. Contraindications and monitoring of TRT were analyzed by comparing available guidelines released in the last five years. We provide a review of advantages and disadvantages of different modalities of TRT and how to monitor treatment to minimize the risks. RESULTS: TRT is associated with multiple benefits highly relevant to the patient. However, the recommendations given in different guidelines on TRT are based on data from a limited number of randomized controlled trials (RCTs), as well as non-randomized clinical studies and observational studies. This is the case for the safety of a long-term TRT in late-onset hypogonadism (LOH). No evidence is provided indeed on the effects of TRT on endpoints such as deterioration of heart failure suggesting a cautious approach to T replacement in older men with a history of heart failure. CONCLUSION: Clinicians must consider the unique characteristics of each patient and make the necessary adjustments in the management of LOH in order to provide the safest and most beneficial results.
Authors: Maria Camila Suarez A; Joseph M Israeli; Eliyahu Kresch; Leon Telis; Daniel E Nassau Journal: Int J Impot Res Date: 2022-01-07 Impact factor: 2.896
Authors: Biagio Barone; Luigi Napolitano; Marco Abate; Luigi Cirillo; Pasquale Reccia; Francesco Passaro; Carmine Turco; Simone Morra; Francesco Mastrangelo; Antonio Scarpato; Ugo Amicuzi; Vincenzo Morgera; Lorenzo Romano; Francesco Paolo Calace; Savio Domenico Pandolfo; Luigi De Luca; Achille Aveta; Enrico Sicignano; Massimiliano Trivellato; Gianluca Spena; Carlo D'Alterio; Giovanni Maria Fusco; Raffaele Vitale; Davide Arcaniolo; Felice Crocetto Journal: Int J Mol Sci Date: 2022-03-24 Impact factor: 5.923
Authors: S Sehmisch; M Komrakova; P J Roch; V Wolgast; M-M Gebhardt; K O Böker; D B Hoffmann; D Saul; A F Schilling Journal: J Endocrinol Invest Date: 2022-04-16 Impact factor: 5.467
Authors: Baris Gencer; Marco Bonomi; Maria Pia Adorni; Cesare R Sirtori; François Mach; Massimiliano Ruscica Journal: Rev Endocr Metab Disord Date: 2021-02-22 Impact factor: 6.514