Androgen therapy has been primarily used for replacement therapy in symptomatic hypogonadal men. Other indications under clinical investigation include androgen replacement therapy for older men with age-associated decline in serum testosterone levels, muscle-wasting disease, male contraception and as adjunctive therapy to oestrogen (and progesterone) hormone replacement for postmenopausal women. Recent scientific and pharmaceutical interests led to development of new long-acting injectables, transdermal delivery systems and sublingual preparations. The benefits of androgen replacement must be weighed against the potential risks when androgens are used in conditions other than male hypogonadism. In the future, designer androgens with specific beneficial effect on sexual function, mood, bone and muscle mass but with attenuated effects on serum lipid profiles and the prostate gland may be developed.