A. Kryger, MD.( unpublished) Hypogonadism is a significant problem in men as they age and leads to both impotence and dwindling libido. The loss of libido is associated with morning total serum testosterone (T) levels at or below 300ng/dl, the customary threshold of hypogonadism. in healthy men. Although injectable testosterone has been used as a treatment for hypogonadal men since 1935, injectable T esters are not only painful, but result in serum T concentrations which "fluctuate widely". Transdermal testosterone has been shown to be more effective than injections for treating hypogonadism with less side effects. Unfortunately, single patches are unable to attain adequate levels of "free" or bioactive T to treat all symptoms. A low T dose hydroalcoholic gel preparation, AndroGel has become available. Our product, Testocreme¨transdermal used in 50 men with low testosterone levels, statistically raised T, FreeT and DHT levels in both saliva and serum. All men in the 3 year clinical study noted an increase in frequency of early morning erections, return of libido and improvement of erectile function. T cream when used as gonadal steroid replacement, had no effect on PSA or LH with shrinkage of prostate or decrease in PSA by more than half of the men in the study. It is hypothesized that increasing DHT restores libido, hair growth and penile fullness.