Description: This book addresses an important issue in endocrinology, the use of testosterone as replacement therapy in hypogonadism. There has been much controversy in the field, in both the definition of hypogonadism itself, as well as the indications, risks, and benefits of testosterone therapy. This multiauthored book tackles these important questions.
Purpose: The purpose is to guide clinicians in the use of testosterone replacement treatments, their respective advantages and disadvantages, and their indications for use. These are important objectives, since options for testosterone replacement therapies have increased in recent years, and there has been a variety of controversies surrounding the potential risks and benefits of such therapies.
Audience: Clinicians who treat men with hypogonadism, including internists, endocrinologists, and urologists, are the intended audience. The authors are all experts in this field.
Features: The book starts with a discussion of hypogonadism, including issues with the definition of this disorder. An explanation of the laboratory measurement of testosterone, free testosterone, and bioactive testosterone follows. After a discussion of CAG repeats on the function of the androgen receptor, the bulk of the book covers various metabolic and other issues in testosterone deficiency and treatment, including obesity, metabolic syndrome, coronary artery disease, erectile dysfunction, osteoporosis, frailty and cognition, and congestive heart failure. The book ends with an exploration of testosterone and prostate safety, with the interesting idea that exogenous testosterone may not increase intra-prostatic concentrations of the hormone.
Assessment: This is a very useful book to learn how testosterone deficiency may impact on a variety of metabolic and other processes, as well as the potential benefits of replacement therapy. Although the various authors do mention the limited studies of both risks and benefits of testosterone therapy, the emphasis in this book is more on possible benefits of treatment than on potential concerns.