USE OF TESTOSTERONE IN PALLETS IN HYPOGONADIC MEN: A NARRATIVE REVIEW

• DOI: https://doi.org/10.22533/at.ed.15952825060810

• Palavras-chave: Testosterone replacement therapy, pellets, male hypogonadism, testosterone therapy, testosterone replacement, andropause.

• Keywords: Testosterone replacement therapy, pellets, male hypogonadism, testosterone therapy, testosterone replacement, andropause.

• Abstract:

  Late-onset hypogonadism (LOH) or male aging androgen decline (MAAD) or andropause is a clinical condition characterized by the presence of symptoms and/or signs associated with biochemical evidence of decreased serum testosterone levels, either in the form of total testosterone or free testosterone, and is increasingly common in men. This clinical situation presents with a compilation of symptoms and signs that are divided into: clinical symptoms and signs of androgen deficiency, sexual symptoms, and cognitive and neurovegetative symptoms. There is a wide range of therapies for replacing serum testosterone levels in patients with LTA or MAAD, with different therapeutic forms, each with advantages and disadvantages. This study is a narrative review that aimed to investigate the specialized health literature of the last 20 years on testosterone replacement therapy (TRT) in men through subcutaneous testosterone pellets in hypogonadal men from 2004 to 2024. The articles were searched in the databases of the Medical Literature Analysis and Retrieval System Online (Medline), Latin American and Caribbean Health Sciences Literature (LILACS), and the Scientific Electronic Library (Scielo). Of the 269 articles found, after reading the abstracts, 37 articles met the inclusion criteria and were analyzed according to the specific theme of this review. The studies show that this is a safe and effective therapeutic modality, with low comorbidity complications, with the experience of the medical professional, insertion technique, insertion geometry, and physical activity after the procedure being significant factors in the occurrence of extrusion and infection. The cost of medication alone is equal to or lower than other therapeutic options, and in the total aggregate, considering the minimally invasive procedure, it is higher, offset by routine medical follow-up. Publications show that the method is highly effective and efficient, with a high patient satisfaction rate and high clinical safety promoting improvement in clinical signs and symptoms, rehabilitation of sexual components, and optimization of neurovegetative signs.