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Late-life onset hypogonadism: a review
1Division of Geriatric Psychiatry, Department of Neurology and Psychiatry, Saint Louis University School of Medicine, St Louis, MO 63104, USA.
Clinics in Geriatric Medicine
|May 26, 2010
Summary
Testosterone replacement therapy (TRT) may benefit aging men with hypogonadism, improving sexual function, mood, and bone health. Potential risks exist but are debated, necessitating physician-patient discussion.
Area of Science:
- Endocrinology
- Men's Health
- Geriatrics
Background:
- Aging populations increase the prevalence of late-onset hypogonadism.
- Diagnosis requires low testosterone levels plus symptoms and signs of hypogonadism.
- Current treatment guidelines emphasize careful patient selection.
Purpose of the Study:
- To review the established and potential benefits of testosterone replacement therapy (TRT).
- To discuss the controversial risks associated with TRT in men.
- To inform clinical decision-making regarding TRT.
Main Methods:
- Literature review of studies on testosterone replacement therapy.
- Analysis of reported benefits across various physiological systems.
- Evaluation of potential risks and contraindications for TRT.
Main Results:
- TRT may improve libido, sexual function, bone density, muscle mass, mood, and quality of life.
- Potential cardiovascular benefits are suggested but require further long-term study.
- Risks include potential worsening of benign prostatic hypertrophy, erythrocytosis, and other adverse effects; prostate cancer stimulation lacks evidence.
Conclusions:
- TRT offers potential benefits for men with confirmed hypogonadism.
- Careful consideration of individual patient risks and benefits is crucial.
- Open communication between physician and patient regarding TRT is essential.
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