To the best of our knowledge, this is the first study to compare the benefits and harms of individual testosterone products among hypogonadal men. Our study builds on previous meta-analyses by comparing the relative effects of individual testosterone treatments, most of which have never been compared in head-to-head trials. When considered as a class (any TRT compared with placebo), TRT improved quality of life, depression, erectile function and libido; however, when the individual products were compared head to head, there were few differences between the treatments. We found no increased risk of major harms; however, this must be viewed in light of the high risk of bias of the included studies, the rare nature of serious harms, and the short treatment duration and follow-up of most studies.
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