Benefícios e riscos da terapia de reposição de testosterona em homens: uma revisão sistemática de literatura

Abstract

Testosterone is the main circulating androgen hormone, secreted by testicular Leydig cells and responsible for male sexual differentiation, sexual potency, muscle growth and several other functions. In this sense, the lack of this hormone in the male body causes psychological and physical damage. One of the alternatives for insufficient levels of this hormone is testosterone replacement therapy. This work aims to review existing articles on the benefits and risks of testosterone replacement therapy, seeking to emphasize the most frequent findings. In this sense, it is related to increase the understanding of the manifestations of low testosterone levels in the human body, being important to understand its findings, contribute to the creation of treatments and reduce the damage related to the psychological and physical health of the patient. To carry out the work, the methodology of integrative literature review will be used, focusing on the most up-to date works related to the treatment, aiming to gather more relevant information about the therapy. Initially, 110 articles were found. Of these, 4 were duplicates, leaving 106 manuscripts, where 74 were excluded for not meeting secondary criteria: Study focused on men, symptomatic, laboratory hypogonadism and over 50 years. Of the 32 articles selected for reading the abstracts, 23 were excluded (12 for not talking about hormone replacement, 7 for focusing on women and 4 electronically unavailable). Remaining only 9 articles that were included in the review. Considering all the articles mentioned, there was a perception of the need for adequate medical management, it is evident that patients with hypogonadism require treatment due to the various symptoms reported. However, the diagnostic investigation must take into account not only the hormone levels, but also the symptomatology of each patient, low total testosterone levels without characteristic symptoms may not be enough to start hormone therapy given the possible side effects. Likewise, patients with testosterone levels in the borderline range and with clear symptomatology may benefit from TRT. In this sense, it is up to the physician to analyze the possible risks presented by TRT compared to the benefits that the patient will have with adequate hormone levels. Once you choose to undergo therapy, the drug administration route must also be an assertive choice, with the aim of facilitating adherence and continuous treatment. It is essential to emphasize the need for periodic follow-up in order to minimize or even prevent possible adverse effects, always with the aim of guaranteeing the well-being of the patient in psychological and physiological aspects.