Neuroendocrine aging in men. Andropause and somatopause

Area of Science:

• Gerontology and endocrinology
• Age-related hormonal changes in men

Background:

• Aging men experience decreased testosterone and growth hormone, impacting body composition and function.
• Hormone replacement therapy (androgens, growth hormone) is explored to counteract these aging effects.
• Effectiveness, benefits, and risks of these interventions require further comprehensive documentation.

Purpose of the Study:

• To review the current evidence on trophic factor interventions for age-related hormonal decline in men.
• To assess the potential benefits and risks of testosterone and growth hormone therapy in older men.
• To identify gaps in knowledge and guide future research directions.

Main Methods:

• Review of small-scale clinical studies on testosterone, growth hormone, and growth hormone secretagogues.
• Analysis of available data on body composition, strength, and functional capacity changes.
• Consideration of ongoing and planned large-scale clinical trials.

Main Results:

• Testosterone therapy up to 36 months can improve body composition in some older men, especially those with low levels (< 2 ng/mL).
• Evidence for growth hormone or secretagogue therapy in healthy older men is limited and does not support general clinical use.
• Data on functional outcomes like strength and daily activities remain sparse, with larger trials needed.

Conclusions:

• Androgen supplementation may benefit selected older men with low testosterone, improving lean mass, bone mass, and potentially strength.
• Growth hormone therapy is not recommended for general use in healthy aging men due to cost and limited evidence.
• Further large-scale trials are essential to establish the risk-benefit profile of hormone therapies in aging men, particularly for functional outcomes.