Testosterone is the principal androgen responsible for the development and maintenance of male reproductive and secondary sexual characteristics. It is synthesized primarily in the Leydig cells of the testes under stimulation from luteinizing hormone (LH), which is secreted by the anterior pituitary gland.
The regulation of testosterone production occurs through the hypothalamic–pituitary–testicular (HPT) axis. Gonadotropin-releasing hormone (GnRH) from the hypothalamus stimulates LH and follicle-stimulating hormone (FSH) secretion. Testosterone exerts negative feedback on both hypothalamus and pituitary, maintaining hormonal equilibrium.
Beyond reproductive function, testosterone influences muscle mass, erythropoiesis, bone density, mood, and metabolic processes. Deficiency may lead to reduced libido, erectile dysfunction, fatigue, sarcopenia, and osteoporosis.
Clinical assessment requires biochemical confirmation of low serum testosterone measured in the morning. Management strategies must balance symptom relief with safety monitoring, particularly regarding hematologic and cardiovascular erotic parameters.
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