Testosterone replacement therapy: clinical considerations

Expert Opin Pharmacother. 2024 Jan-Apr;25(1):25-35. doi: 10.1080/14656566.2024.2306832. Epub 2024 Feb 1.


Introduction: As an increasingly popular therapeutic option, testosterone replacement therapy (TRT) has gained significant notoriety for its health benefits in indicated populations, such as those suffering from hypogonadism.

Areas covered: Benefits such as improved libido, muscle mass, cognition, and quality of life have led to widened public interest in testosterone as a health supplement. No therapy exists without side effects; testosterone replacement therapy has been associated with side effects such as an increased risk of polycythemia, benign prostate hypertrophy (BPH), prostate cancer, gynecomastia, testicular atrophy, and infertility. Testosterone replacement therapy is often accompanied by several prophylactic co-therapies aimed at reducing the prevalence of these side effects. Literature searches for sections on the clinical benefits and risks associated with TRT were performed to include clinical trials, meta-analyses, and systematic reviews from the last 10 years.

Expert opinion: Data from clinical studies over the last decade suggest that the benefits of this therapy outweigh the risks and result in overall increased quality of life and remission of symptoms related to hypogonadism. With this in mind, the authors of this review suggest that carefully designed clinical trials are warranted for the investigation of TRT in symptomatic age-related hypogonadism.

Keywords: TRT; Testosterone; hypogonadism; prostate; testosterone replacement therapy.

Publication types

  • Review

MeSH terms

  • Humans
  • Hypogonadism* / chemically induced
  • Hypogonadism* / diagnosis
  • Hypogonadism* / drug therapy
  • Libido
  • Male
  • Prostatic Neoplasms* / drug therapy
  • Quality of Life
  • Testosterone / adverse effects


  • Testosterone