Types of Treatment

Several therapeutic options are available in the treatment of adult hypogonadism, the choice of which depend on the clinical situation, availability/costs of medications, patient expectations, and preferences. The induction or restoration of both fertility and testosterone (T) production are potentially achievable, in patients with secondary hypogonadism, whereas only T substitution is effective when the testes are damaged (i.e. primary hypogonadism). When fertility is desired, the use of gonadotrophins in secondary hypogonadism is the most appropriate treatment allowing sperm production to be achieved in about 50% of cases. In all other patients, T substitution is the treatment of choice as it is cheaper and easier to administer when compared to gonadotropins. The use of transdermal T preparations and long-acting injectable T undecanoate are currently the most popular forms of the treatment worldwide. They generally achieve a high level of efficacy with limited side effects.