Byrne M, Nieschlag E
Institute of Reproductive Medicine, University of Münster, Münster, Germany.
J Endocrinol Invest. 2003 May;26(5):481-9. doi: 10.1007/BF03345206.
In human males 6-7 mg of testosterone are secreted by the testes in a circadian rhythm with a nocturnal rise in testosterone followed by a decline during the day. Testosterone is necessary to induce and maintain secondary sexual characteristics, lean muscle mass, bone density and for normal sexual behaviour and cognitive function in men. Replacement therapy has been shown to be beneficial in men with overt hypogonadism. Natural testosterone should be used and not modified molecules. Testosterone is currently available in oral, intramuscular, subcutaneous and transdermal preparations. Recent advances in testosterone replacement therapy include testosterone gels which provide flexibility in dosing and minimal skin irritation resulting in good compliance, and the development of longer acting intramuscular preparations which result in more stable testosterone levels with longer injection intervals. All patients receiving testosterone should be carefully monitored for changes in hematocrit, liver function, lipid parameters and prostate specific antigen (PSA).This article reviews the current experience with the use of various forms of testosterone for the treatment of male hypogonadism.
在成年男性中，睾丸以昼夜节律分泌6 - 7毫克睾酮，夜间睾酮水平升高，随后在白天下降。睾酮对于诱导和维持男性第二性征、瘦肌肉量、骨密度以及正常性行为和认知功能是必需的。已证明替代疗法对明显性腺功能减退的男性有益。应使用天然睾酮而非修饰分子。睾酮目前有口服、肌肉注射、皮下注射和透皮制剂。睾酮替代疗法的最新进展包括睾酮凝胶，其在给药方面具有灵活性，皮肤刺激性最小，从而导致良好的依从性，以及长效肌肉注射制剂的开发，其可在更长的注射间隔下使睾酮水平更稳定。所有接受睾酮治疗的患者都应密切监测血细胞比容、肝功能、血脂参数和前列腺特异性抗原（PSA）的变化。本文综述了目前使用各种形式睾酮治疗男性性腺功能减退的经验。
