Hypogonadism in the Aging Male Diagnosis, Potential Benefits, and Risks of Testosterone Replacement Therapy

Overview

Journal Int J Endocrinol

Publisher Wiley

Specialty Endocrinology

Date 2012 Apr 17

PMID 22505891

Citations 55

Authors

Prasanth N Surampudi

Christina Wang

Ronald Swerdloff

Affiliations

Soon will be listed here.

Abstract

Hypogonadism in older men is a syndrome characterized by low serum testosterone levels and clinical symptoms often seen in hypogonadal men of younger age. These symptoms include decreased libido, erectile dysfunction, decreased vitality, decreased muscle mass, increased adiposity, depressed mood, osteopenia, and osteoporosis. Hypogonadism is a common disorder in aging men with a significant percentage of men over 60 years of age having serum testosterone levels below the lower limits of young male adults. There are a variety of testosterone formulations available for treatment of hypogonadism. Data from many small studies indicate that testosterone therapy offers several potential benefits to older hypogonadal men. A large multicenter NIH supported double blind, placebo controlled study is ongoing, and this study should greatly enhance the information available on efficacy and side effects of treatment. While safety data is available across many age groups, there are still unresolved concerns associated with testosterone therapy. We have reviewed the diagnostic methods as well as benefits and risks of testosterone replacement therapy for hypogonadism in aging men.

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References

Wehr E, Pilz S, Boehm B, Marz W, Obermayer-Pietsch B . Association of vitamin D status with serum androgen levels in men. Clin Endocrinol (Oxf). 2010; 73(2):243-8. DOI: 10.1111/j.1365-2265.2009.03777.x. View

Ip F, Di Pierro I, Brown R, Cunningham I, Handelsman D, Liu P . Trough serum testosterone predicts the development of polycythemia in hypogonadal men treated for up to 21 years with subcutaneous testosterone pellets. Eur J Endocrinol. 2009; 162(2):385-90. DOI: 10.1530/EJE-09-0717. View

Merza Z, Blumsohn A, Mah P, Meads D, McKenna S, Wylie K . Double-blind placebo-controlled study of testosterone patch therapy on bone turnover in men with borderline hypogonadism. Int J Androl. 2006; 29(3):381-91. DOI: 10.1111/j.1365-2605.2005.00612.x. View

Morgentaler A . Testosterone replacement therapy and prostate cancer. Urol Clin North Am. 2007; 34(4):555-63, vii. DOI: 10.1016/j.ucl.2007.08.002. View

Haider A, Gooren L, Padungtod P, Saad F . Concurrent improvement of the metabolic syndrome and lower urinary tract symptoms upon normalisation of plasma testosterone levels in hypogonadal elderly men. Andrologia. 2009; 41(1):7-13. DOI: 10.1111/j.1439-0272.2008.00880.x. View

Goncharov N, Katsya G, Dobracheva A, Nizhnik A, Kolesnikova G, Todua T . Serum testosterone measurement in men: evaluation of modern immunoassay technologies. Aging Male. 2006; 8(3-4):194-202. DOI: 10.1080/13685530500355566. View

Page S, Mohr B, Link C, ODonnell A, Bremner W, McKinlay J . Higher testosterone levels are associated with increased high-density lipoprotein cholesterol in men with cardiovascular disease: results from the Massachusetts Male Aging Study. Asian J Androl. 2007; 10(2):193-200. PMC: 2666971. DOI: 10.1111/j.1745-7262.2008.00332.x. View

Kim Y . Testosterone supplementation in the aging male. Int J Impot Res. 2000; 11(6):343-52. DOI: 10.1038/sj.ijir.3900446. View

Bhasin S, Calof O, Storer T, Lee M, Mazer N, Jasuja R . Drug insight: Testosterone and selective androgen receptor modulators as anabolic therapies for chronic illness and aging. Nat Clin Pract Endocrinol Metab. 2006; 2(3):146-59. PMC: 2072878. DOI: 10.1038/ncpendmet0120. View

10.

Selvin E, Feinleib M, Zhang L, Rohrmann S, Rifai N, Nelson W . Androgens and diabetes in men: results from the Third National Health and Nutrition Examination Survey (NHANES III). Diabetes Care. 2007; 30(2):234-8. DOI: 10.2337/dc06-1579. View

11.

Ly L, Sartorius G, Hull L, Leung A, Swerdloff R, Wang C . Accuracy of calculated free testosterone formulae in men. Clin Endocrinol (Oxf). 2010; 73(3):382-8. DOI: 10.1111/j.1365-2265.2010.03804.x. View

12.

Rosen R, Araujo A, Connor M, Gerstenberger E, Morgentaler A, Seftel A . The NERI Hypogonadism Screener: psychometric validation in male patients and controls. Clin Endocrinol (Oxf). 2010; 74(2):248-56. DOI: 10.1111/j.1365-2265.2010.03925.x. View

13.

Dandona P, Dhindsa S, Chaudhuri A, Bhatia V, Topiwala S . Hypogonadotrophic hypogonadism in type 2 diabetes. Aging Male. 2008; 11(3):107-17. DOI: 10.1080/13685530802317934. View

14.

Liu H, Paige N, Goldzweig C, Wong E, Zhou A, Suttorp M . Screening for osteoporosis in men: a systematic review for an American College of Physicians guideline. Ann Intern Med. 2008; 148(9):685-701. DOI: 10.7326/0003-4819-148-9-200805060-00009. View

15.

Nieschlag E, Behre H, Bouchard P, Corrales J, Jones T, Stalla G . Testosterone replacement therapy: current trends and future directions. Hum Reprod Update. 2004; 10(5):409-19. DOI: 10.1093/humupd/dmh035. View

16.

Cherrier M, Matsumoto A, Amory J, Asthana S, BREMNER W, Peskind E . Testosterone improves spatial memory in men with Alzheimer disease and mild cognitive impairment. Neurology. 2005; 64(12):2063-8. DOI: 10.1212/01.WNL.0000165995.98986.F1. View

17.

Isidori A, Giannetta E, Gianfrilli D, Greco E, Bonifacio V, Aversa A . Effects of testosterone on sexual function in men: results of a meta-analysis. Clin Endocrinol (Oxf). 2005; 63(4):381-94. DOI: 10.1111/j.1365-2265.2005.02350.x. View

18.

Muller M, Aleman A, Grobbee D, de Haan E, van der Schouw Y . Endogenous sex hormone levels and cognitive function in aging men: is there an optimal level?. Neurology. 2005; 64(5):866-71. DOI: 10.1212/01.WNL.0000153072.54068.E3. View

19.

Mazer N . A novel spreadsheet method for calculating the free serum concentrations of testosterone, dihydrotestosterone, estradiol, estrone and cortisol: with illustrative examples from male and female populations. Steroids. 2009; 74(6):512-9. DOI: 10.1016/j.steroids.2009.01.008. View

20.

Wylie K, Froggatt N . Late onset hypogonadism, sexuality and fertility. Hum Fertil (Camb). 2010; 13(3):126-33. DOI: 10.3109/14647273.2010.501890. View