Treating hypogonadism in younger males.
BACKGROUND
Hypogonadism in the young and middle-aged male is a well-established clinical entity. The majority of the patients have primary gonadal insufficiency with Klinefelter syndrome a common cause. Secondary hypogonadism in these age groups can be congenital, secondary to medications, or associated with a hypothalamic-pituitary mass or inflammatory lesions. Signs and symptoms in males with hypogonadism can include impaired sexuality, decreased muscle strength, increased body fat, decreased bone mass, impaired mood and mild anemia; in young patients puberty can be delayed. Several new treatment modalities have become available in recent years and a number of future compounds are in development.
This review explores the treatment options for children, young adult and middle-aged males with hypogonadism related to various etiologies, including currently available and future testosterone formulations and other non-testosterone compounds. The long-term treatment effects, particularly on prostate health, remain unclear and may be particularly relevant for the younger patient initiated on chronic therapy; treatment monitoring and recommended clinical follow-up based on current guidelines are also reviewed.


CONCLUSIONS
Hypogonadism in younger males can be the result of a diversity of etiologies. Treatment options for hypogonadism and induction of puberty have expanded and can be individualized based on patient preference, side effect profile, and a number of other parameters.
Yin
Anthony
A
Harbor-UCLA Medical Center and LA Biomedical Research Institute, David Geffen School of Medicine at UCLA, 1000 West Carson St., Torrance, CA 90509, USA.
Swerdloff
Ronald
R
D000293:Adolescent; D000328:Adult; D002675:Child, Preschool; D006801:Humans; D007006:Hypogonadism / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D013739:Testosterone / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*
D013739:Testosterone