Male hypogonadism (low testosterone [low T]) is a condition characterized by impaired spermatogenesis and low serum testosterone. The majority of cases are caused by low T driven by age or comorbidities (e.g., obesity). Testosterone replacement therapy (TRT), which aims to increase overall serum testosterone levels, is the cornerstone of treatment and is primarily administered via injection or topical means. However, a key drawback of TRT is decreased spermatogenesis, and some alternative therapies for low T focus on stimulating gonadotropins to preserve fertility. Additionally, the FDA has cautioned against the use of TRT due to the possibility of increased cardiac risk. Here, we will evaluate U.S. physician prescribing and treatment strategies in this arena.
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