Purpose and Overview

Even though the decline in testosterone with aging is not uniform and universal, a low testosterone among middle-aged men has been a very common issue and the testosterone replacement therapy (TRT) has been on high demand. The current literature presents a landscape of contradictory and confusing data. Challenges with testosterone assays include interpersonal and inter-racial variation, as well as intra- and inter-assay validity issues. There is no universally accepted age-related normal testosterone value range. The appropriate threshold level for TRT remains a subject of debate. Complaints such as sexual dysfunction, particularly erectile dysfunction (ED) and fatigue, prompt evaluation and treatment of male hypogonadism. The benefit of TRT to relieve those symptoms are not uniform and sustained. There has been a concern for long-term safety of testosterone replacement therapy (TRT) due to potential risks such as Venous Thromboembolism, cardiovascular safety and prostate safety. Selecting the appropriate patient who would have the most benefit and the lowest risk of TRT is the critical task for all clinicians. The purpose of this talk is to discuss the caveats of latest literature related to testosterone replacement therapy for adult male hypogonadism. At the end of the talk, the audience will be able address the common questions and concerns related to TRT.