The most recent erectile dysfunction (ED) consensus guidelines recommend evaluation of the hypothalamic–pituitary–gonadal axis, including total T, bioavailable T (BT), and free T (FT), ‘in patients with sexual dysfunction and at risk of or suspected of hypogonadism.’ 2 These guidelines designate testosterone as a second-line therapy. Sexual dysfunction, particularly low libido, is among the most readily reversible symptoms of male hypogonadism.
1 The fundamental aim of TRT is to restore serum T to eugonadal levels and minimize signs and symptoms of hypogonadism. Testosterone replacement therapy (TRT) has been administered to men with hypogonadism for decades.