For hypogonadal men who are still interested in maintaining their fertility, I would avoid any of the above options as they tend to suppress pituitary function and thus testicular production of sperm. Off-label options to consider are chorionic gonadotropin (for direct testicular stimulation by mimicking LH & FSH) and clomiphene (by inducing the pituitary to produce more LH & FSH). These latter options might be beyond the comfort level of many primary care physicians but are certainly not without support in published literature. The take home point? Make sure you're aware of all your options and make sure your treatment is individualized to you. Follow @alvinblin
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