Treatment of Hypogonadism: Current and Future Therapies

Abstract

The treatment of hypogonadism in men is of great interest to both patients and providers. There are a number of testosterone formulations currently available and several additional formulations under development. In addition, there are some lesser-used alternative therapies for the management of male hypogonadism, which may have advantages for certain patient groups. The future of hypogonadism therapy may lie in the development of selective androgen receptor modulators that allow the benefits of androgens whilst minimizing unwanted side effects.

Clomiphene citrate and human chorionic gonadotropin are both effective in restoring testosterone in hypogonadism: a short‐course randomized study

“…Therapy with hCG therapy (recombinant hCG) is traditionally used in men with hypogonadism desiring fertility because it shares a receptor with LH and produces similar effects. The dose is usually titrated to a serum testosterone concentration in the mid‐ to normal range . Kobori et al.…”

“…Therapy with hCG therapy (recombinant hCG) is traditionally used in men with hypogonadism desiring fertility because it shares a receptor with LH and produces similar effects. The dose is usually titrated to a serum testosterone concentration in the mid-to normal range [22]. Kobori et al [23] reported both successful improvement in chemistry (increase in serum testosterone) and symptoms in seven men (aged 34-45 years) with azoospermia and/or sexual dysfunction, with a low serum testosterone concentration after using hCG 5000 twice weekly [23].…”

Selective Androgen Receptor Modulators: Current Knowledge and Clinical Applications

“…Testosterone therapy (TTh) is currently the mainstay treatment for hypogonadism and is an option for treating cancer related cachexia. [15,51] Although TTh is effective in treating hypogondal symptoms, it possesses potential side effects that require careful monitoring. [51] TTh can lead to gynecomastia due to estrogen aromatization, erythrocytosis, reduced spermatogenesis, acne, male pattern baldness, and undesirable alterations in serum lipids, among other effects.…”

Secondary adrenal insufficiency and pituitary dysfunction in oral/transdermal opioid users with non-cancer pain

“…Our data suggest however, that individuals suffering from biochemical hypogonadism are difficult to distinguish based on symptomatic sexual dysfunction. Information required to identify the best management strategies includes determining which individuals benefit from treatment and whether other potential means of increasing testosterone are effective in these patients such as opioid dose reduction, rotation of opioid formulation or the use of alternative therapy such as clomiphene citrate (42).…”