Hypogonadism

Joseph P. Alukal, MD, Editor

Hypogonadism (testosterone deficiency) is a prevalent condition that has become increasingly controversial. Recent studies raise the question of whether or not testosterone replacement is overprescribed and unacceptably risky from a cardiac health standpoint. This perception of risk is now present within the lay press and much of the lay population.

This controversy ignores the fact that hormone replacement therapy in male patients has been used for many years, and it has been studied from a number of different angles. The relationship between testosterone and prostate cancer physiology resulted in a Nobel Prize almost five decades ago; scientists have been studying testosterone and its relationship to sexual function, heart health, diabetes, bone density, and muscle development for more than one hundred years. Included in this issue is the clinical experience and research expertise of many of the leaders in this effort.

This issue of Urologic Clinics of North America is designed to help patients and practitioners better understand this common and controversial problem. A thorough discussion of the physiology of testosterone in the male, the options for testosterone replacement and their risks, as well as future directions for this field are included herein. Given the public health impact of this bothersome condition, this work is timely and needed; we hope it will guide clinicians in the proper management of their hypogonadal patients.

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