Male hypogonadism and testosterone replacement therapy

The causes of male hypogonadism can be classified into primary (testicular) and secondary (central). This review discusses the indications for testosterone replacement therapy, provides a practical clinical guide to managing this therapy and reviews its use in non-gonadal illness such as HIV. It summarizes the preparations available for testosterone replacement, with emphasis on newer delivery systems, and discusses the adverse effects of testosterone treatment, including prostate cancer and polycythaemia. Recent studies on the safety of testosterone with regard to cardiovascular safety and thromboembolism are discussed.