Endocrinology Update: Testicular Hypogonadism

Area of Science:

• Endocrinology
• Men's Health
• Andrology

Background:

• Testicular hypogonadism, or androgen deficiency, results from the hypothalamic-pituitary-gonadal axis disruption.
• Testosterone deficiency (TD) is defined as serum testosterone levels below 300 ng/dL.
• Over one-third of men aged 45 and older may experience TD.

Purpose of the Study:

• To define testicular hypogonadism and testosterone deficiency.
• To outline associated symptoms and their link to cardiometabolic parameters.
• To discuss the controversy surrounding testosterone replacement therapy (TRT) risks and benefits.

Main Methods:

• Review of clinical definitions and diagnostic criteria for TD.
• Analysis of symptoms associated with TD.
• Examination of the relationship between TD and cardiometabolic parameters.
• Evaluation of existing literature on TRT in men with hypogonadism.

Main Results:

• TD is characterized by low testosterone levels and associated symptoms like decreased libido, fatigue, and erectile dysfunction.
• TD is linked to adverse cardiometabolic parameters, including insulin resistance, hypertension, and hyperlipidemia.
• While TRT may improve TD symptoms and cardiometabolic factors, concerns remain regarding potential cardiovascular risks.

Conclusions:

• Testosterone deficiency is a prevalent condition in aging men with diverse symptoms and cardiometabolic implications.
• The management of TD, particularly the decision for TRT, requires careful consideration of potential benefits against debated risks.
• Further research is needed to clarify the long-term cardiovascular effects of TRT in men with hypogonadism.