Testosterone replacement therapy

Testosterone replacement therapy is a well-tolerated and established treatment for hypogonadism, providing excellent clinical and biochemical relief from the effects of sex steroid deficiency. This review gives a practical clinical guide to managing testosterone replacement therapy. It outlines the indications for testosterone replacement, including the relevant testosterone threshold levels for treatment. There is also discussion of its use in non-gonadal illness such as HIV. Recent studies looking at the use of testosterone in cardiometabolic disease are discussed. The routes of administrating testosterone replacement therapy are summarized, with emphasis on the newer delivery systems that have become available recently. There is a discussion of the side effects of testosterone treatment including its effects on the prostate and haematological parameters. Finally, an outline of both safety and clinical testosterone level monitoring is presented.