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Testosterone for the aging male; current evidence and recommended practice
Roger D Stanworth1, T Hugh Jones
1Centre of Diabetes and Endocrinology, Barnsley Hospital NHS Foundation Trust, Barnsley, South Yorkshire, United Kingdom.
Clinical Interventions in Aging
|May 21, 2008
Summary
This consensus document guides the diagnosis and treatment of late-onset hypogonadism (LOH) in men. It addresses controversies in diagnosis and testosterone therapy, balancing risks and benefits for improved quality of life.
Area of Science:
- Endocrinology
- Men's Health
- Geriatrics
Background:
- Late-onset hypogonadism (LOH) diagnosis and management remain challenging due to non-specific symptoms in aging men.
- Defining diagnostic criteria and testosterone thresholds for LOH is controversial.
- Current testosterone assays have limitations, impacting accurate assessment of bioavailable or free testosterone.
Purpose of the Study:
- To provide guidance on the diagnosis, treatment, and monitoring of late-onset hypogonadism (LOH) in men.
- To review the benefits and risks associated with testosterone therapy.
- To address controversies surrounding LOH diagnosis and management.
Main Methods:
- Review of an international consensus document.
- Analysis of current literature on LOH diagnosis and testosterone treatment.
- Discussion of emerging evidence on testosterone's effects and potential concerns.
Main Results:
- Diagnosis of LOH requires both biochemical and clinical evaluation.
- Testosterone treatment aims to improve sexual function, mood, strength, and quality of life.
- Emerging benefits include potential improvements in bone density, obesity, and insulin resistance, alongside risks like polycythemia.
Conclusions:
- Testosterone therapy for LOH should be individualized, balancing risks and benefits.
- Newer testosterone preparations offer reliable physiological serum concentrations.
- Ongoing research is crucial for refining LOH diagnosis and management strategies.
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