title: Emerging medication for the treatment of male hypogonadism.
abstract: BACKGROUND
  Male hypogonadism is characterized by inadequate production of Testosterone (T) (hypoandrogenism) and deficiencies in spermatogenesis. The main treatment of male hypogonadism is T replacement therapy (TRT), but for some of the patients, alternative drugs may be more suitable.
  
  
  METHODS
  The available literature of T and alternative treatments for male hypogonadism are discussed.
  
  
  CONCLUSIONS
  Transdermal application of T gels are the most commonly used route of T administration. Some oral T formulations are either associated with hepatic toxicity (i.e. methyltestosterone) or short half-lives that require multiple doses per day (i.e. oral testosterone undecanoate). Short acting, injectable T formulations are also available. If the patient prefers not to use daily drugs or short acting injectable formulations, depot formulations such as injectable testosterone undecanoate (TU) may be a good alternative. If the patient has hypogonadotropic hypogonadism and desires fertility or if he is adolescent, instead of TRT, gonadotropins can be started to stimulate testicular growth and spermatogenesis. In obese patients or for the patients having high risks for TRT, off label aromatase inhibitors (AI) and clomiphene citrate (CC), may be considered to stimulate LH, FSH and T levels. In patients with high prostate disease risk, selective androgen receptor modulators may be an alternative treatment but these latter treatments have not had high level evidence.
authors.affiliation: a Division of Endocrinology, Department of Medicine , Harbor-UCLA Medical Center , Torrance , CA , USA.|b Department of Endocrinology and Metabolism , Gulhane School of Medicine , Ankara , Turkey.
authors.forename: Aydogan
authors.initials: A
authors.lastname: Aydogdu
authors.affiliation: a Division of Endocrinology, Department of Medicine , Harbor-UCLA Medical Center , Torrance , CA , USA.
authors.forename: Ronald S
authors.initials: RS
authors.lastname: Swerdloff
mesh_terms: D000279:Administration, Cutaneous; D000293:Adolescent; D000728:Androgens / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D000818:Animals; D005782:Gels; D020249:Hormone Replacement Therapy / Q000379:methods; D006801:Humans; D007006:Hypogonadism / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D013739:Testosterone / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000728:Androgens; D005782:Gels; D013739:Testosterone
keywords: Male hypogonadism; aromatase inhibitors (AIs); clomiphene citrate (CC); dehydroepiandrosterone (DHEA); dihydrotestosterone (DHT); human chorionic gonadotropin (hCG); testosterone 2% gel; testosterone 5% cream; testosterone gel 1.62%; testosterone undecanoate (TU)