Aging and the Male Reproductive System
Jean-Marc Kaufman1, Bruno Lapauw1, Ahmed Mahmoud1
1Department of Endocrinology, Ghent University Hospital, Ghent, Belgium.
Endocrine Reviews
|March 20, 2019
Summary
Aging men experience reproductive hormone changes, including declining testosterone. While some symptoms may improve with testosterone therapy, its broad use in older men is not justified due to unproven long-term safety and limited benefits.
Area of Science:
- Endocrinology
- Andrology
- Geriatrics
Background:
- Aging men experience gradual changes in reproductive hormones and fertility.
- Factors like comorbidities significantly influence these hormonal shifts.
- Testosterone (T) therapy is considered for various age-related symptoms.
Purpose of the Study:
- To review current knowledge on male reproductive hormone changes with aging.
- To examine the clinical consequences of these changes.
- To evaluate the benefits and risks of testosterone therapy in older men.
Main Methods:
- Narrative review of existing literature.
- Analysis of factors influencing hormonal changes.
- Assessment of clinical outcomes and treatment effects.
Main Results:
- Aging men show mild declines in total T, steeper free T decline, and increased SHBG and LH.
- Testosterone therapy shows limited benefits for body composition, metabolic health, and physical function.
- Benefits for mood and vitality exist in elderly men with low T, but long-term safety is unknown.
Conclusions:
- Broad "testosterone replacement therapy" for older men is not justified by current evidence.
- Clinical consequences of low T and treatment benefits are moderate.
- Long-term safety and efficacy of testosterone therapy in aging men require further investigation.
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