Male hypogonadism is a condition characterized by impaired spermatogenesis and low serum testosterone. In adult men, it can be caused by intrinsic abnormalities in the testes or changes in upstream pituitary or hypothalamic signaling pathways contributing to testosterone biosynthesis. Male hypogonadism driven by age or comorbidities (e.g., obesity or type 2 diabetes) represent the majority of cases of low testosterone in adult men. Testosterone replacement therapy (TRT), which aims to increase overall serum testosterone levels, is the cornerstone therapy for male hypogonadism and is primarily administered via injection or topical means. However, a key drawback of TRTs is decreased spermatogenesis, and some alternative therapies for low testosterone focus on the stimulation of gonadotropins in an effort to preserve fertility. Additionally, the FDA has recently cautioned against the use of TRT due to the possibility of increased cardiac risk, and this study will evaluate potential changes to physician prescribing and treatment strategies through real-world data analyses.
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