Obesity and late-onset hypogonadism

Area of Science:

• Endocrinology
• Metabolic Health
• Reproductive Health

Background:

• Obesity and male hypogonadism (HG) are frequently associated, exhibiting a bidirectional relationship.
• Prospective studies confirm HG increases visceral obesity risk and obesity induces incident HG.
• This review explores the interplay and pathogenic mechanisms between obesity and HG.

Purpose of the Study:

• To review the bidirectional relationship between obesity and male hypogonadism.
• To discuss pathogenic considerations, including hypothalamic inflammation and GnRH release.
• To evaluate treatment strategies for obesity-induced HG and the role of testosterone supplementation.

Main Methods:

• Meta-analysis of intervention studies on obesity treatment for HG.
• Review of pathogenic mechanisms linking obesity to HG.
• Analysis of controlled studies on testosterone supplementation in obese hypogonadal men.

Main Results:

• Obesity treatment is highly effective for obesity-induced HG.
• Obesity may induce HG via dietary-induced hypothalamic inflammation and decreased GnRH release.
• Testosterone supplementation in obese hypogonadal men increases lean mass and decreases fat mass, potentially improving exercise adherence.

Conclusions:

• The relationship between obesity and male hypogonadism is bidirectional.
• Treating obesity is a key strategy for managing obesity-induced HG.
• Testosterone supplementation may indirectly support weight management by enhancing physical activity capacity.