Androgen replacement therapy should be prescribed for all hypogonadal men. Before commencement of replacement, contraindications to androgen treatment should be identified. In hypogonadal men, androgens improve sexual function, energy, and mood; increase muscle mass and strength; and increase BMD. Androgen therapy can be tailored to each patient's needs and preferences. There are many new androgen delivery systems introduced in the past few years, and many others are in development. SARMs may have the potential of optimizing beneficial effects while minimizing potential adverse effects. In older men, monitoring of prostate dysfunction and red-cell indexes are necessary and important. With care, androgens can be used efficaciously and with minimal potential side effects.
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