Transdermal Testosterone Gel (Androgel®): A breakthrough in Testosterone Replacement Therapy (TRT)
18 Mar 2025
byJoanne G. Blanco, MD
Key points:
Figure 1. Urologists listen to one of the speakers of the symposium as they discuss a redefined TRT approach
Summit chair stresses the importance of a holistic approach to men’s health through TRT
Paul L. Reyes, Country Head of Besins Healthcare, opened the event by highlighting the company’s long-standing dedication to men’s health. As one of the oldest pharmaceutical companies globally, Besins Healthcare aims to provide effective, convenient TRT solutions that enhance patient compliance and safety. Reyes underscored the importance of accessible TRT in the Philippines, positioning Besins as a proponent of men’s health and a pioneer in offering solutions like Androgel® to address testosterone deficiency.
Russelyn M. Quetua, Men’s Health Senior Product Manager at Besins Healthcare Phils, Inc., opened the summit with an insightful overview. The sessions were carefully structured to address key topics, challenges, and management strategies for testosterone deficiency across both segments. Renowned specialists shared their expertise on TRT, fostering meaningful discussions and engagement with attendees during the panel session. Through this initiative, Besins Healthcare Phils, Inc. continues to advance research and collaboration between urology and endocrinology, pushing the boundaries of innovation in men’s health.
Summit Chair Dr Enrique Ian S. Lorenzo, a urologist, highlighted the need for a paradigm shift in how physicians approach testosterone deficiency. He stressed that men’s health, particularly issues related to testosterone, should be addressed comprehensively rather than reactively. Dr Lorenzo noted the traditional hesitancy in recommending TRT, largely due to misconceptions about testosterone’s role in prostate health. However, recent evidence shows that TRT, when properly managed, can significantly improve men’s quality of life, leading him to advocate for a proactive approach in offering TRT as a treatment option.1-3
Figure 2. Panelists and speakers in the symposium. From left: Dr Enrique lan S. Lorenzo, Ms. Russelyn M. Queta, Dr Nikko J. Magsanoc, Dr Jose Dante P. Dator, Dr Nemencio A. Nicodemus, Dr Rica Vina P. Cruz, Dr Norwin T Uy, Dr Roberto C. Mirasol, and Mr. Paul L. Reyes.
Urologists prioritize addressing testosterone deficiency
In the opening session, Dr Jose Dante P. Dator discussed the often-overlooked issue of testosterone deficiency and its impact on men’s health. He emphasized that men rarely disclose symptoms of testosterone deficiency, such as low libido and erectile dysfunction (ED) unless directly asked by healthcare providers. Dr Dator introduced the concept of “male menopause” or andropause, noting that testosterone levels naturally decline starting around age 40. He cited findings from the Philippine Male Aging Survey conducted by the The Philippine Society for the Study of the Aging Male Foundation, Inc. (PhiSSAM), which showed that nearly 40% of men in the study had low testosterone but only a fraction received treatment due to limited awareness and concerns about cardiovascular risks.
TRAVERSE trial provides reassurance on TRT safety in hypogonadal men
Dr Dator referenced the TRAVERSE Trial, a landmark study that explored the safety of TRT in men with hypogonadism, focusing on cardiovascular outcomes. Conducted in 2015, the study enrolled men aged 45 to 80 with testosterone levels below 300 ng/dL and observed them over several years. Results indicated no significant increase in cardiovascular events among those receiving TRT compared to the placebo group, challenging previous concerns and supporting the use of TRT in hypogonadal men with careful monitoring.2
TRT shifts views as additional testosterone fails to stimulate prostate tissue growth
Dr Dator also addressed the long-standing misconception that TRT exacerbates prostate cancer risk. He presented the “saturation model,” proposed by Dr Abraham Morgentaler, which posits that beyond a certain point, additional testosterone does not further stimulate prostate tissue growth. This model has been validated by studies such as the 2015 International Expert Consensus, encouraging urologists to consider TRT in men without active prostate cancer.4
Figure 3. Primary Cardiovascular Composite Safety End Point for the Safety Population. The graph shows the cumulative incidence of the primary cardiovascular composite safety end point, which was defined as death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. TRT was noninferior to placebo with respect to the incidence of major adverse cardiac events (hazard ratio 0.96, 95% CI, 0.78 to 1.17).
Endocrine factors influence testosterone levels and TRT’s impact on quality of life
Endocrinologist Dr Nemencio A. Nicodemus provided an endocrinological perspective on testosterone deficiency and replacement therapy. He detailed the hypothalamic-pituitary-testicular (HPT) axis. He discussed factors that influence testosterone levels, such as obesity and type 2 diabetes, both of which reduce sex hormone-binding globulin (SHBG) and subsequently decrease free testosterone levels.5
Meta-analysis shows TRT’s positive effects on body composition and cardiovascular health
Dr Nicodemus shared findings from a meta-analysis examining TRT’s effects on body weight and waist circumference in men with obesity. The results indicated that TRT can reduce abdominal fat and improve muscle mass, leading to better overall metabolic health. Another metaanalysis he presented showed that TRT was associated with a reduction in cardiovascular morbidity and mortality, challenging earlier concerns about TRT’s cardiovascular risks.6
TRAVERSE trial validates TRT’s cardiovascular safety
Echoing Dr Dator’s remarks, Dr Nicodemus also cited the TRAVERSE Trial to reinforce TRT’s cardiovascular safety in hypogonadal men. He emphasized that, when used responsibly, TRT has minimal adverse effects on cardiovascular health, thereby providing an essential tool for improving the quality of life in men with testosterone deficiency.2
TRT improves quality of life and sexual function
Dr Nicodemus noted that TRT has shown significant improvements in sexual health, mood, and energy levels. He referenced a study that found that TRT significantly improved scores on the International Index of Erectile Function (IIEF-15), underscoring TRT’s role in enhancing patients’ quality of life and mental health outcomes.7
There is a potential to make TRT accessible in the Philippines
In the third session, Dr Nikko J. Magsanoc focused on the accessibility and practical aspects of TRT in the Philippines, particularly through Androgel®. He explained that serum testosterone testing remains challenging due to limited access and high costs, making it difficult for physicians to diagnose and monitor testosterone deficiency effectively.
TRAVERSE trial shows evidence supporting the cardiovascular safety of TRT
Dr Magsanoc referenced the TRAVERSE Trial to address lingering concerns about cardiovascular risks associated with TRT. He explained that the trial, which enrolled over 5,000 men aged 45 to 80 with testosterone levels below 300 ng/dL, found no significant difference in major adverse cardiovascular events (MACE) between those treated with TRT and those given a placebo. Over a median follow-up of 33 months, the trial provided robust evidence that TRT, when administered appropriately, does not increase cardiovascular risks. This reassurance allows Filipino healthcare providers to recommend TRT, including Androgel®, with greater confidence, particularly for patients with controlled cardiovascular conditions.2
Androgel® heralded as a viable treatment of choice for Filipino men with low testosterone
Dr Magsanoc highlighted the redefined approach to TRT and Androgel®’s transdermal delivery as a safe and convenient TRT method that bypasses some risks associated with injectable and maternal forms of testosterone. Citing studies showing high compliance rates with transdermal TRT, he emphasized Androgel®’s suitability for Filipino men who may struggle with the accessibility and affordability of regular testosterone treatments. This practical approach has the potential to significantly increase adherence and provide a sustainable TRT option in the local healthcare landscape.8
Men’s sexual health has emotional and relational impacts
Clinical Sexologist Dr Rica Vina P. Cruz provided a unique perspective on the psychological and relational effects of men’s sexual health concerns. She noted that men often feel stigmatized when discussing sexual health issues, particularly those related to testosterone deficiency. Dr Cruz emphasized that healthcare providers should be proactive in asking patients about their sexual health concerns to help them feel more comfortable discussing these issues.
Open communication mitigates psychological toll of sexual dysfunction
Dr Cruz explained that sexual dysfunction and low testosterone can lead to significant psychological distress, affecting self-esteem, mental health, and interpersonal relationships. She encouraged practitioners to consider the emotional burden of these issues and to collaborate with mental health professionals when necessary to support patients holistically.9
Collaborative care between urologists and mental health experts encourages improved management
Dr Cruz advocated for an integrated care approach, where urologists and mental health experts work together to manage patients with complex cases involving both physiological and psychological aspects of testosterone deficiency. By fostering an environment of open communication and multidisciplinary support, she believes that TRT can be optimized to benefit men’s overall mental and relational health.
Panel discussion examines practical challenges and addresses misconceptions in TRT
The symposium concluded with a panel discussion featuring experts in urology and endocrinology, including Dr Norwin T. Uy, Dr Roberto C. Mirasol, and Summit Chair Dr Lorenzo. Panelists addressed common barriers to TRT, such as concerns about cardiovascular and prostate health, and examined recent evidence that has reframed these issues. They encouraged practitioners to focus on evidence-based recommendations and to consider TRT in patients presenting with symptoms of testosterone deficiency.
Conclusion
The Act with the Experts symposium successfully highlighted the transformative potential of TRT for managing testosterone deficiency. By presenting recent advances, including key studies like the TRAVERSE Trial, and fostering a multidisciplinary approach, the event encouraged healthcare providers to adopt a holistic perspective on TRT. With accessible solutions like Androgel® and a greater understanding of the psychosocial impact of testosterone deficiency, Filipino practitioners are well-positioned to improve the quality of life for men across the country.
Androgel®/Testogel is the No.1 global* leader in transdermal testosterone products in value & volume.
*Source: IQVIA MIDAS® for the time period MATERNAL Q2 2023; Geography: 61 countries. Copyright IQVIA. All rights reserved.
Androgel® Addresses the Conditions of Testosterone Deficiencies with no compromise on symptoms such as CV and Prostate Health.
References: 1. Bhasin S, Travison TG, et al. JAMA Netw Open 2023;6:e2348692. 2. Lincoff AM, et al. N Engl J Med 2023;389:107–117. 3. Chedrawe E, et al. Androgens: Clinical Research and Therapeutics 2022;3.1:180–186. 4. Morgentaler A, et al. European Urology 2009;55;310–321. 5. Sharma A, Jayasena CN, Dhillo WS. Endocrinol Metab Clin North Am 2022 Mar;51:29-45. 6. Kaur H, Werstuck GH. CJC Open 2021;3(10):1238-1248. 7. Cruickshank M, Hudson J, et al. Health Technol Assess 2024;28:1-210. 8. Swerdloff RS, Wang C, et al. The Journal of Clinical Endocrinology & Metabolism 2000;85(12):4500–4510. 9. Indirli R, Lanzi V, et al. Front Endocrinol (Lausanne) 2023;14:1198437.
Embark on a new era in the management of testosterone levels in your patients.
Unlock the potential of Androgel® today!
For full prescribing information, please scan the QR code.
Besins Healthcare Philippines, Inc.
17/F High Street South Corporate Plaza Tower 2, 26th St. cor 11th Ave. Bonifacio Global City, Taguig City Philippines
- TRAVERSE trial provides reassurance on testosterone replacement therapy (TRT) safety in hypogonadal men
- TRT shifts views as additional testosterone fails to stimulate prostate tissue growth
- Meta-analysis shows TRT’s positive effects on body composition and cardiovascular health
- Androgel® heralded as a viable treatment of choice for Filipino men with low testosterone
- Collaborative care between urologists and mental health experts encourages improved management of testosterone deficiency
On September 28, 2024, Besins Healthcare Philippines, Inc. Men’s Health team gathered healthcare professionals to discuss the latest advancements in TRT in
an event entitled, “Act with the Experts: Navigating the New Era of TRT, A multidisciplinary approach in TRT management.” This event brought together experts
in urology, endocrinology, and clinical sexology to address testosterone deficiency and its implications for men’s health, especially in the Philippines. The
symposium emphasized the importance of a well-rounded approach to TRT, focusing on updated evidence, practical challenges, and the psychosocial aspects
of therapy.
Figure 1. Urologists listen to one of the speakers of the symposium as they discuss a redefined TRT approachSummit chair stresses the importance of a holistic approach to men’s health through TRT
Paul L. Reyes, Country Head of Besins Healthcare, opened the event by highlighting the company’s long-standing dedication to men’s health. As one of the oldest pharmaceutical companies globally, Besins Healthcare aims to provide effective, convenient TRT solutions that enhance patient compliance and safety. Reyes underscored the importance of accessible TRT in the Philippines, positioning Besins as a proponent of men’s health and a pioneer in offering solutions like Androgel® to address testosterone deficiency.
Russelyn M. Quetua, Men’s Health Senior Product Manager at Besins Healthcare Phils, Inc., opened the summit with an insightful overview. The sessions were carefully structured to address key topics, challenges, and management strategies for testosterone deficiency across both segments. Renowned specialists shared their expertise on TRT, fostering meaningful discussions and engagement with attendees during the panel session. Through this initiative, Besins Healthcare Phils, Inc. continues to advance research and collaboration between urology and endocrinology, pushing the boundaries of innovation in men’s health.
Summit Chair Dr Enrique Ian S. Lorenzo, a urologist, highlighted the need for a paradigm shift in how physicians approach testosterone deficiency. He stressed that men’s health, particularly issues related to testosterone, should be addressed comprehensively rather than reactively. Dr Lorenzo noted the traditional hesitancy in recommending TRT, largely due to misconceptions about testosterone’s role in prostate health. However, recent evidence shows that TRT, when properly managed, can significantly improve men’s quality of life, leading him to advocate for a proactive approach in offering TRT as a treatment option.1-3
Figure 2. Panelists and speakers in the symposium. From left: Dr Enrique lan S. Lorenzo, Ms. Russelyn M. Queta, Dr Nikko J. Magsanoc, Dr Jose Dante P. Dator, Dr Nemencio A. Nicodemus, Dr Rica Vina P. Cruz, Dr Norwin T Uy, Dr Roberto C. Mirasol, and Mr. Paul L. Reyes.Urologists prioritize addressing testosterone deficiency
In the opening session, Dr Jose Dante P. Dator discussed the often-overlooked issue of testosterone deficiency and its impact on men’s health. He emphasized that men rarely disclose symptoms of testosterone deficiency, such as low libido and erectile dysfunction (ED) unless directly asked by healthcare providers. Dr Dator introduced the concept of “male menopause” or andropause, noting that testosterone levels naturally decline starting around age 40. He cited findings from the Philippine Male Aging Survey conducted by the The Philippine Society for the Study of the Aging Male Foundation, Inc. (PhiSSAM), which showed that nearly 40% of men in the study had low testosterone but only a fraction received treatment due to limited awareness and concerns about cardiovascular risks.
TRAVERSE trial provides reassurance on TRT safety in hypogonadal men
Dr Dator referenced the TRAVERSE Trial, a landmark study that explored the safety of TRT in men with hypogonadism, focusing on cardiovascular outcomes. Conducted in 2015, the study enrolled men aged 45 to 80 with testosterone levels below 300 ng/dL and observed them over several years. Results indicated no significant increase in cardiovascular events among those receiving TRT compared to the placebo group, challenging previous concerns and supporting the use of TRT in hypogonadal men with careful monitoring.2
TRT shifts views as additional testosterone fails to stimulate prostate tissue growth
Dr Dator also addressed the long-standing misconception that TRT exacerbates prostate cancer risk. He presented the “saturation model,” proposed by Dr Abraham Morgentaler, which posits that beyond a certain point, additional testosterone does not further stimulate prostate tissue growth. This model has been validated by studies such as the 2015 International Expert Consensus, encouraging urologists to consider TRT in men without active prostate cancer.4
Figure 3. Primary Cardiovascular Composite Safety End Point for the Safety Population. The graph shows the cumulative incidence of the primary cardiovascular composite safety end point, which was defined as death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. TRT was noninferior to placebo with respect to the incidence of major adverse cardiac events (hazard ratio 0.96, 95% CI, 0.78 to 1.17).Endocrine factors influence testosterone levels and TRT’s impact on quality of life
Endocrinologist Dr Nemencio A. Nicodemus provided an endocrinological perspective on testosterone deficiency and replacement therapy. He detailed the hypothalamic-pituitary-testicular (HPT) axis. He discussed factors that influence testosterone levels, such as obesity and type 2 diabetes, both of which reduce sex hormone-binding globulin (SHBG) and subsequently decrease free testosterone levels.5
Meta-analysis shows TRT’s positive effects on body composition and cardiovascular health
Dr Nicodemus shared findings from a meta-analysis examining TRT’s effects on body weight and waist circumference in men with obesity. The results indicated that TRT can reduce abdominal fat and improve muscle mass, leading to better overall metabolic health. Another metaanalysis he presented showed that TRT was associated with a reduction in cardiovascular morbidity and mortality, challenging earlier concerns about TRT’s cardiovascular risks.6
TRAVERSE trial validates TRT’s cardiovascular safety
Echoing Dr Dator’s remarks, Dr Nicodemus also cited the TRAVERSE Trial to reinforce TRT’s cardiovascular safety in hypogonadal men. He emphasized that, when used responsibly, TRT has minimal adverse effects on cardiovascular health, thereby providing an essential tool for improving the quality of life in men with testosterone deficiency.2
TRT improves quality of life and sexual function
Dr Nicodemus noted that TRT has shown significant improvements in sexual health, mood, and energy levels. He referenced a study that found that TRT significantly improved scores on the International Index of Erectile Function (IIEF-15), underscoring TRT’s role in enhancing patients’ quality of life and mental health outcomes.7
There is a potential to make TRT accessible in the Philippines
In the third session, Dr Nikko J. Magsanoc focused on the accessibility and practical aspects of TRT in the Philippines, particularly through Androgel®. He explained that serum testosterone testing remains challenging due to limited access and high costs, making it difficult for physicians to diagnose and monitor testosterone deficiency effectively.
TRAVERSE trial shows evidence supporting the cardiovascular safety of TRT
Dr Magsanoc referenced the TRAVERSE Trial to address lingering concerns about cardiovascular risks associated with TRT. He explained that the trial, which enrolled over 5,000 men aged 45 to 80 with testosterone levels below 300 ng/dL, found no significant difference in major adverse cardiovascular events (MACE) between those treated with TRT and those given a placebo. Over a median follow-up of 33 months, the trial provided robust evidence that TRT, when administered appropriately, does not increase cardiovascular risks. This reassurance allows Filipino healthcare providers to recommend TRT, including Androgel®, with greater confidence, particularly for patients with controlled cardiovascular conditions.2
Androgel® heralded as a viable treatment of choice for Filipino men with low testosterone
Dr Magsanoc highlighted the redefined approach to TRT and Androgel®’s transdermal delivery as a safe and convenient TRT method that bypasses some risks associated with injectable and maternal forms of testosterone. Citing studies showing high compliance rates with transdermal TRT, he emphasized Androgel®’s suitability for Filipino men who may struggle with the accessibility and affordability of regular testosterone treatments. This practical approach has the potential to significantly increase adherence and provide a sustainable TRT option in the local healthcare landscape.8
Men’s sexual health has emotional and relational impacts
Clinical Sexologist Dr Rica Vina P. Cruz provided a unique perspective on the psychological and relational effects of men’s sexual health concerns. She noted that men often feel stigmatized when discussing sexual health issues, particularly those related to testosterone deficiency. Dr Cruz emphasized that healthcare providers should be proactive in asking patients about their sexual health concerns to help them feel more comfortable discussing these issues.
Open communication mitigates psychological toll of sexual dysfunction
Dr Cruz explained that sexual dysfunction and low testosterone can lead to significant psychological distress, affecting self-esteem, mental health, and interpersonal relationships. She encouraged practitioners to consider the emotional burden of these issues and to collaborate with mental health professionals when necessary to support patients holistically.9
Collaborative care between urologists and mental health experts encourages improved management
Dr Cruz advocated for an integrated care approach, where urologists and mental health experts work together to manage patients with complex cases involving both physiological and psychological aspects of testosterone deficiency. By fostering an environment of open communication and multidisciplinary support, she believes that TRT can be optimized to benefit men’s overall mental and relational health.
Panel discussion examines practical challenges and addresses misconceptions in TRT
The symposium concluded with a panel discussion featuring experts in urology and endocrinology, including Dr Norwin T. Uy, Dr Roberto C. Mirasol, and Summit Chair Dr Lorenzo. Panelists addressed common barriers to TRT, such as concerns about cardiovascular and prostate health, and examined recent evidence that has reframed these issues. They encouraged practitioners to focus on evidence-based recommendations and to consider TRT in patients presenting with symptoms of testosterone deficiency.
Conclusion
The Act with the Experts symposium successfully highlighted the transformative potential of TRT for managing testosterone deficiency. By presenting recent advances, including key studies like the TRAVERSE Trial, and fostering a multidisciplinary approach, the event encouraged healthcare providers to adopt a holistic perspective on TRT. With accessible solutions like Androgel® and a greater understanding of the psychosocial impact of testosterone deficiency, Filipino practitioners are well-positioned to improve the quality of life for men across the country.
Androgel®/Testogel is the No.1 global* leader in transdermal testosterone products in value & volume.
*Source: IQVIA MIDAS® for the time period MATERNAL Q2 2023; Geography: 61 countries. Copyright IQVIA. All rights reserved.
Androgel® Addresses the Conditions of Testosterone Deficiencies with no compromise on symptoms such as CV and Prostate Health.
References: 1. Bhasin S, Travison TG, et al. JAMA Netw Open 2023;6:e2348692. 2. Lincoff AM, et al. N Engl J Med 2023;389:107–117. 3. Chedrawe E, et al. Androgens: Clinical Research and Therapeutics 2022;3.1:180–186. 4. Morgentaler A, et al. European Urology 2009;55;310–321. 5. Sharma A, Jayasena CN, Dhillo WS. Endocrinol Metab Clin North Am 2022 Mar;51:29-45. 6. Kaur H, Werstuck GH. CJC Open 2021;3(10):1238-1248. 7. Cruickshank M, Hudson J, et al. Health Technol Assess 2024;28:1-210. 8. Swerdloff RS, Wang C, et al. The Journal of Clinical Endocrinology & Metabolism 2000;85(12):4500–4510. 9. Indirli R, Lanzi V, et al. Front Endocrinol (Lausanne) 2023;14:1198437.
Embark on a new era in the management of testosterone levels in your patients.
Unlock the potential of Androgel® today!
For full prescribing information, please scan the QR code.
Besins Healthcare Philippines, Inc.
17/F High Street South Corporate Plaza Tower 2, 26th St. cor 11th Ave. Bonifacio Global City, Taguig City Philippines