During male ageing important changes occur in the neuroendocrine environment. The most remarkable are the decreased secretion of melatonin, growth hormone, dehydroepiandrosterone, and testosterone. Hormone replacement with each one of these substances has been proposed, but few data are available on the long-term effects. Today, testosterone replacement seems to offer the most promising option. New delivery systems are under development that can restore circulating physiological testosterone levels, including circadian variability. Limited experience with a novel sustained release buccal tablet given to ageing men with subnormal testosterone concentrations suggests that optimal replacement decreases cholesterol, triglycerides, and prostate specific antigen (PSA) levels, without inducing any change in haematocrit or other vital parameters.