[Towards a consensus regarding androgen substitution therapy for andropause].

"Andropause" or "male climateric" refer to the term "menopause" in the women. The parallelism between both entities is however only partial since the decrease of gonadal function in the male is very different from one individual to the other. Some men present a gonadal deficiency together with an increase gonadotropin function as early as in the 40s while others show normal testicular function at 80 or later! It appears that besides genetic factors many life events (stress, obesity, sedentarity...) can "precipitate" testicular failure. Besides the major symptoms of sexual impotency and loss of libido, testosterone deficiency also induces reversible modification in lipid profile, muscle strength, bone density ... and on some cognitive and psychological parameters. It is therefore reasonable to treat androgen deficiency in early or late aging provided a cautious urological check-up has been realized before treatment. The mode of administration (i.m., p.o., or transdermal) will depend on the principal goal of the treatment and on the wish of the patient! An annual clinical and biological urological assessment is mandatory.