TESTOSTERONE REPLACEMENT THERAPY IN MEN WITH HYPOGONADISM –  REVIEW OF LITERATURE

Jakub Majewski; Oliwia Wróblewska; Maria Kaniecka; Anna Karcz; Barbara Pająk; Małgorzata Dworniczak; Sofiya Salash; Aleksandra Romaniuk; Hubert Bołdys-Żegocki; Artur Koza

doi:10.31435/ijitss.4(48).2025.4391

Authors

Jakub Majewski Hospital Murcki Limited Liability Company, Katowice, Poland https://orcid.org/0009-0009-3368-3817
Oliwia Wróblewska University Clinical Center of the Medical University of Silesia in Katowice, Katowice, Poland https://orcid.org/0009-0004-8848-3832
Maria Kaniecka Hospital Murcki Limited Liability Company, Katowice, Poland https://orcid.org/0009-0007-6755-4154
Anna Karcz Beskid Oncology Center - Municipal Hospital of John Paul II in Bielsko-Biała, Poland https://orcid.org/0009-0007-8381-0541
Barbara Pająk Beskid Oncology Center - Municipal Hospital of John Paul II in Bielsko-Biała, Poland https://orcid.org/0009-0004-8148-7216
Małgorzata Dworniczak Hospital Murcki Limited Liability Company, Katowice, Poland https://orcid.org/0009-0006-8005-5774
Sofiya Salash Beskid Oncology Center - Municipal Hospital of John Paul II in Bielsko-Biała, Poland https://orcid.org/0009-0009-9725-8457
Aleksandra Romaniuk Regional Specialist Hospital in Biała Podlaska, Poland https://orcid.org/0009-0002-7036-3985
Hubert Bołdys-Żegocki Medical University of Silesia in Katowice, Katowice, Silesia, Poland https://orcid.org/0009-0003-2124-0919
Artur Koza Regional Specialist Hospital in Biała Podlaska, Poland https://orcid.org/0009-0001-9714-1154

DOI:

https://doi.org/10.31435/ijitss.4(48).2025.4391

Keywords:

Hypogonadism, Testosterone, Testosterone Replacement Therapy, Metabolic Syndrome, Diabetes, Fertility, Controversies

Abstract

Testosterone replacement therapy (TRT) is the fundamental intervention in the treatment of male hypogonadism. Despite many years of clinical experience, in recent years the benefits and risks of TRT have been intensely discussed. The aim of this review article is to summarize the current state of knowledge on the pathophysiology of hypogonadism, diagnostic criteria, indications and effects of therapy, taking into account different patient groups. An analysis of available scientific publications was conducted, including clinical trials, meta-analyses, and official expert guidelines. The results of the review indicate that testosterone therapy significantly improves sexual function in men (including libido and erection) and has a beneficial effect on well-being. An increase in muscle mass, improvement in body composition (increase in lean mass and reduction of visceral fat), and also an increase in bone mineral density were observed. At the same time, attention is drawn to possible adverse effects of TRT, such as the development of polycythemia (elevated hematocrit), inhibition of sperm production, and potential exacerbation of obstructive sleep apnea symptoms in some patients. Testosterone therapy can bring significant benefits in the treatment of hypogonadism, especially in terms of improving sexual function and overall quality of life. However, the choice of treatment should be tailored to the patient in each case, taking into account possible risks, such as cardiovascular risk or impact on fertility. Due to remaining uncertainties, further prospective studies are necessary to more precisely assess the long-term safety of testosterone therapy.

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