Toxicity in

The administration of androgens to sexually mature hy-pogonadal men is associated with few untoward effects. However, prepuberal or hypogonadal males never exposed to testosterone show enhanced sensitivity to administered androgens, and many do not like the effects. Testosterone administration can cause irritability, agitation, or aggressive behavior. Androgen administration to normal males inhibits the release of the pituitary go-nadotropins FSH, LH, and as a consequence, endogenous testicular production of testosterone is reduced. Spermatogenesis is also reduced, and if administration is continued, azoospermia and infertility may result. Peripheral aromatization of androgens to estrogens can cause gynecomastia. Cessation of exogenous androgen treatment in normal males usually results in restoration of normal sperm levels over a 6-month period. Finally, androgen replacement therapy in elderly men should be monitored closely. Men at this age are at risk for developing prostatic neoplasms (benign and malignant), and use of androgens in this setting is contraindicated because of the likelihood of stimulating growth of these tumors.

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