Abstract
Guidelines for testosterone replacement therapy (TRT) have been well studied and defined in adults, however, this remains less defined for adolescents and young men. There are a variety of conditions in adolescents and young men that necessitate TRT. These conditions range from genetic etiologies such as Kallmann syndrome and Klinefelter syndrome, to acquired causes such as testicular trauma. Conditions can be broadly classified as hypogonadotropic hypogonadism or hypergonadotropic hypogonadism, depending on whether there are concurrently elevated gonadotropins (follicle-stimulating hormone (FSH) and luteinizing hormone (LH)). The decision to initiate TRT in these cases is multifaceted, contributing to the challenge of formulating clear guidelines. In this review, we utilized online sources such as PubMed and Google Scholar to find relevant literature, using key words such as testosterone therapy, adolescents and hormone replacement and hypogonadism in adolescents. This narrative review explores existing literature on TRT in adolescents and young men, encompassing common etiologies of hypogonadism in this population, available TRT therapies, and management and surveillance protocols. Furthermore, it addresses the evolving field of TRT in transgender youth. This study underscores the necessity for additional clinical investigations to explore emerging TRT therapies and establish clear surveillance guidelines tailored to this population.