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Andropause. Testosterone replacement therapy for aging men.

J Bain1

  • 1Department of Medicine, University of Toronto, Ontario.

Canadian Family Physician Medecin De Famille Canadien
|February 24, 2001
PubMed
Summary
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Testosterone replacement therapy can benefit aging men with low or low-normal testosterone levels, improving symptoms like fatigue and low libido. Studies show positive responses with minimal side effects, supporting its use in carefully selected patients.

Area of Science:

  • Endocrinology
  • Andrology
  • Geriatrics

Background:

  • Aging men often experience a decline in testosterone levels, a condition sometimes referred to as andropause.
  • This decline can lead to a range of symptoms including reduced libido, erectile dysfunction, fatigue, and mood disturbances.
  • While large-scale prospective studies are limited, existing evidence is based on physiological and open-label treatment assessments.

Purpose of the Study:

  • To review the rationale for testosterone replacement therapy (TRT) in aging men with mildly reduced or low-normal testosterone levels.
  • To discuss the symptoms associated with low testosterone and potential underlying causes.
  • To evaluate the existing evidence regarding the efficacy and safety of TRT.

Main Methods:

  • Review of physiologic studies and available treatment assessment data.

Related Experiment Videos

  • Analysis of uncontrolled, open-label studies on testosterone treatment.
  • Consideration of clinical complaints and laboratory findings indicative of hypoandrogenism.

    • Main Results:

    • Hypoandrogenism should be suspected in men with symptoms like loss of libido, erectile dysfunction, weakness, fatigue, lethargy, loss of motivation, or mood swings.
    • Reduced testosterone levels may also be associated with anemia and osteoporosis.
    • Most men undergoing testosterone treatment report subjective improvements in well-being and quality of life, with few serious adverse events.
    • Primary gonadal insufficiency is the most common cause of reduced testosterone, but secondary causes like hypothalamic-pituitary disease must also be considered.

    Conclusions:

    • Andropause is a clinical concept describing symptoms in aging men with low testosterone.
    • Physicians should consider testing for low testosterone in symptomatic aging men.
    • Testosterone replacement therapy should be carefully considered for selected patients with confirmed low testosterone levels.