Male hypogonadism is characterized by low serum testosterone and impaired spermatogenesis. Primary male hypogonadism results from an intrinsic abnormality in the testes, while secondary male hypogonadism is a deficit of testosterone driven by changes in pituitary or hypothalamic upstream signaling pathways. Secondary hypogonadism is the predominant form of male hypogonadism in the major markets, and the incidence of secondary hypogonadism increases as a result of the age-related accumulation of comorbidities such as obesity. TRT, which aims to increase overall serum testosterone levels, is the cornerstone therapy for male hypogonadism and is primarily administered via injection or topical means. However, a key drawback of TRTs is decreased spermatogenesis, and some alternative therapies for male hypogonadism focus on the stimulation of gonadotropins in an effort to preserve fertility. Additionally, the FDA recently cautioned against the use of TRT due to the possibility of increased cardiac risk. This study will evaluate physicians’ perception of this warning and how this safety issue will affect the uptake of current and emerging therapies for male hypogonadism.


  • Which testosterone formulations will dominate the TRT market in 2026?
  • What impact will emerging TRTs have on an entrenched market of injectable and topical TRTs?
  • Which alternative therapies are likely to trigger changes in current treatment?
  • How is the prevalent male hypogonadism population in the U.S. and EU5 expected to grow over the next ten years?


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Table of contents

  • Male Hypogonadism - Landscape & Forecast - Disease Landscape & Forecast

Author(s): James Heeres, PhD

James is a part of the infectious, niche markets, and rare diseases team at DRG. His work involves evaluating treatment landscape, unmet needs, emerging therapy positioning, commercial potential, drug development opportunities, and company competitiveness. Currently, his concentration is in hepatitis C virus (HCV) infection in US and EU5 markets.

James earned his Ph.D. in biochemistry from the University of Illinois at Urbana-Champaign while studying high-throughput screening technologies and small-molecule inhibitors of apoptosis. Prior to joining DRG, his postdoctoral studies involved drug discovery and development in neurodegenerative diseases at both Harvard Medical School and Boston University School of Medicine.