The clinical administration of exogenous testosterone, typically via injection, transdermal patch, or gel, to restore physiological levels in individuals diagnosed with clinically significant hypogonadism, or testosterone deficiency. This therapeutic intervention aims to alleviate symptoms such as fatigue, decreased libido, reduced muscle mass, and impaired bone density, thereby improving overall quality of life and metabolic health. It requires careful clinical monitoring and dose titration to ensure safety and efficacy.
Origin
The term is a compound of the key hormone (‘Testosterone’) and the clinical application (‘Therapy’). The history of testosterone use dates back to the 1930s, evolving from crude extracts to modern, bioidentical formulations. Current clinical guidelines emphasize the necessity of clear diagnostic criteria and a thorough risk-benefit analysis before initiating treatment. The goal is to restore the endocrine environment to a state of optimal function.
Mechanism
Exogenous testosterone binds to androgen receptors (AR) in target tissues, including muscle, bone, and the central nervous system, where it acts as a nuclear transcription factor to modulate gene expression. The therapy also provides substrate for aromatization into estradiol, which is essential for bone health and neurocognitive function. Clinical success depends on achieving a steady, physiological level of the hormone while managing potential side effects, such as erythrocytosis or suppression of the hypothalamic-pituitary-gonadal axis.
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