Androgen Replacement Therapy: An Overview

Men throughout recorded history have sought to preserve and enhance their virility, and have approached this in several creative ways. In antiquity, the testes were thought to be the seat of both vigor and longevity for men. Greek and Roman men consumed a substance called “satyricon,” a combination of goat and wolf testicular extracts. In the 19th and 20th centuries, there was an emergence of therapies derived from organs: consumption of thyroid extract and animal testicular extract were thought to aid in maintaining virility. In the 1930s, technology progressed and it became possible to isolate various androgens (testosterone propionate, androsterone, methyltestosterone) from animal tissue. These substances began to be applied in clinical situations (Freeman, Bloom, & McGuire, 2001). Testosterone has a complex variety of roles in male physiology. It is a common belief that testosterone in men declines with age. While this is true, there are several aspects to this decline which make it difficult to diagnose definitively, as other endocrine components can contribute to a patient’s symptoms. There are some guidelines to help determine when to begin treatment, based on laboratory assays and symptomatology. Testosterone replacement in men can improve overall quality of life, can reverse some of the effects of hypogonadism, and can be done very safely with available pharmacologic agents.