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Androgen Deficiency in Men Without Overt Pituitary-Gonadal Disease: The Role of Testosterone Therapy

  • Chapter
Sex Hormone Replacement Therapy

Part of the book series: Endocrine Updates ((ENDO,volume 8))

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Abstract

The beneficial effects of testosterone replacement have been unequivocally demonstrated only in the classical androgen-deficiency syndrome associated with disorders of the hypothalamic-pituitary-testicular axis. The only other clinical disorder where the use of androgenic steroids has been shown to alter disease outcome is hereditary angioneurotic edema. There is increasing interest in exploring the use of androgens for clinical disorders in which low testosterone levels are the result of a systemic illness. These syndromes that are associated with a higher prevalence of low testosterone levels than is observed in the general population include chronic illness, aging, and osteoporosis. Because of the potentially large market that patients with these disorders represent for androgenic products, a very substantial effort is underway both in the academic community and in the pharmaceutical industry to develop selective androgenic agonists with defined properties that might have therapeutic applications in these disorders. There are two major uncertainties in the area at this time. First, androgen deficiency in these clinical disorders has been defined solely in terms of low testosterone levels because we do not have good biological markers of testosterone action in the target organs. Second, we do not know whether testosterone replacement therapy can produce clinical significant changes in health-related outcomes in any of these disorders, with the exception of hereditary angioneurotic edema. The use of androgenic steroids in these disorders should, therefore, be viewed as investigational at this time.

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Authors and Affiliations

  1. Charles R Drew University of Medicine and Science, Los Angeles, CA, 90059, USA

    Shalender Bhasin

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  1. Shalender Bhasin
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  1. Monash Medical Centre, Prince Henry’s Institute of Medical Research, Melbourne, Victoria, Australia

    Henry G. Burger

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Bhasin, S. (2000). Androgen Deficiency in Men Without Overt Pituitary-Gonadal Disease: The Role of Testosterone Therapy. In: Burger, H.G. (eds) Sex Hormone Replacement Therapy. Endocrine Updates, vol 8. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-6507-6_6

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