Testosterone treatment to mimic hormone physiology in androgen replacement therapy. A view on testosterone gel and other preparations available.
There is still considerable controversy concerning the issue of testosterone replacement therapy. This is because testosterone replacement therapy is not a 'risk-free' treatment and a randomized controlled trial to evaluate safety of prolonged testosterone replacement therapy is not available, nor is it likely to be in the near future. However, recent testosterone delivery systems, such as the 1% gel (Testogel, Androgel and Testim), have proven to have a good physiologic profile, allowing constant monitoring of the possible complications and prompt discontinuation in the event of adverse effects. The aim of this paper is to provide a comprehensive review of the available testosterone preparations to treat male hypogonadism, with special interest in the treatment of ageing men and late-onset hypogonadism. In addition, the experimental and clinical data on the effect of testosterone on sexual function domains is reviewed along with the indication for the combination therapy of androgens with pro-erectile drugs, for example, type 5 phosphodiesterase inhibitors.
Fabbri
Andrea
A
Università Tor Vergata, Cattedra di Endocrinologia, UOC Endocrinologia, Ospedale S. Eugenio, Rome, Italy. andrea.fabbri@uniroma2.it
Giannetta
Elisa
E
Lenzi
Andrea
A
Isidori
Andrea M
AM
D015106:3',5'-Cyclic-GMP Phosphodiesterases / Q000037:antagonists & inhibitors; D054706:Cyclic Nucleotide Phosphodiesterases, Type 5; D016503:Drug Delivery Systems; D007172:Erectile Dysfunction / Q000188:drug therapy; D005782:Gels; D020249:Hormone Replacement Therapy; D006801:Humans; D007006:Hypogonadism / Q000188:drug therapy*; D008297:Male; D010879:Piperazines / Q000008:administration & dosage; D011687:Purines / Q000008:administration & dosage; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000008:administration & dosage; D013739:Testosterone / Q000008:administration & dosage* / Q000378:metabolism
D005782:Gels; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D013739:Testosterone; D000068677:Sildenafil Citrate; D015106:3',5'-Cyclic-GMP Phosphodiesterases; D054706:Cyclic Nucleotide Phosphodiesterases, Type 5; C517381:PDE5A protein, human