Late-onset hypogonadism (LOH) represents a common clinical entity among aging males.

Typical sexual symptoms suggestive of androgen deficiency comprise loss of libido, decreased spontaneous erections and erectile dysfunction.

Testosterone replacement therapy (TRT) should be offered to these individuals, only if a combination of testosterone deficiency symptoms and low testosterone is present.

Management of aging men with LOH should include individual evaluation of co-morbidities and careful risk—benefit assessment.

Evidence from large randomized prospective trials regarding beneficial effects and cardiovascular safety of testosterone replacement therapy is needed.