Benefits and adverses effects of testosterone therapy

Abstract

Testosterone plays an essential role in several aspects of men’s health. The main indication for testosterone treatment is in men with a confirmed diagnosis of hypogonadism, signs of androgen deficiency, and low serum testosterone levels. Other possible indications include constitutional delay of growth and puberty, men with sexual dysfunction, female to male transgender persons, androgen deficiency in the aging male, hypogonadism secondary to drugs, and chronic illness. Common drug-related adverse events include increase in hematocrit, acne, breast tenderness, gynecomastia, and exogenous testosterone can lead to a state of transitory infertility. It is not recommended to begin testosterone replacement therapy in men with untreated severe obstructive sleep apnea or with benign prostatic hypertrophy. The effects of testosterone on lipid metabolism and cardiovascular risk remain uncertain. In each situation the testosterone replacement brings specific benefits but the overall goals of therapy are to establish and maintain secondary sexual characteristics, sexual function, sense of well-being, and to improve body composition, muscle mass and strength, bone mineral density, and quality of life.