Hippokratia 1999, 3(3):104-115
D. Panidis, A. Kourtis
The goals of hormonal treatment of andropenia depend upon the stage of sexual development in which gonadal failure occurs. Androgen replacement therapy is used to induce and maintain normal secondary sexual characteristics, sexual function, and behavior in pre-pubertal boys and men with either primary or secondary hypogonadism. Parenteral testosterone esters are the most effective, safe, practical, and inexpensive androgen preparations available for this purpose. They are the treatment of choice for androgen replacement therapy. In boys or men with secondary hypogonadism gonadotropin or GnRH therapy may be used instead of testosterone therapy to stimulate endogenous testosterone production. Because of their greater expense and complexity, however, these modalities are usually reserved for men with gonadotropic deficiency, who desire fertility and in whom spermatogenesis must be initiated and maintained.