Adjunct Management of Male Hypogonadism

Abstract

While testosterone replacement therapy (TRT) has been the main strategy in the management of male hypogonadism, the significant risks associated with TRT have driven the search for alternative strategies to treat hypogonadism. With the high preponderance of secondary and mixed-dysfunction hypogonadism, medications such as clomiphene citrate, aromatase inhibitors, and human chorionic gonadotropin (HCG), which target the hypothalamus/pituitary portions of the hypothalamus-pituitary-gonadal axis, have increasingly been studied despite not being FDA-approved for treatment of male hypogonadism. While these agents have demonstrated some promise in managing male hypogonadism, the current evidence behind their use remains weak and there is a need for well-designed, prospective trials that can further elucidate the roles for these agents in the management of male hypogonadism.