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Perspectives

Testosterone replacement therapy: a practical guide to initiation and monitoring

Stella Sarlos, Carolyn A. Allan

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Abstract

Several preparations of testosterone are available but the key factors in determining the most suitable preparation are convenience, ease of administration and safety for the individual. Testosterone replacement therapy should not be prescribed until the diagnostic work up is complete.

Key Points

  • A thorough work up should be completed before commencing testosterone replacement therapy (TRT) to determine the underlying cause of androgen deficiency.
  • Men with proven androgen deficiency, in the absence of contraindications, should be offered TRT.
  • The choice of testosterone preparation will reflect the individual’s concurrent medical history and personal choice.
  • Fertility plans of all men should be discussed before commencing TRT. TRT suppresses spermatogenesis and the duration of this effect varies depending on the formulation used.
  • Monitoring of testosterone levels in men receiving TRT will differ according to the preparation prescribed.

Figures

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© MONKEY BUSINESS IMAGES/ISTOCKPHOTO.COM MODELS USED FOR ILLUSTRATIVE PURPOSES ONLY