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Male Reproduction and Aging.
Maria Gabriela Figueiredo1, Thiago Gagliano-Jucá2, Shehzad Basaria3
1Division of Endocrinology and Metabolism, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, BLI 541, Boston, MA 02115, USA; Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Endocrinology and Metabolism Clinics of North America
|March 22, 2023
Summary
Late-onset hypogonadism is uncommon. Testosterone therapy offers modest benefits for some older men, but risks for prostate cancer and cardiovascular events require further study.
Area of Science:
- Endocrinology
- Men's Health
- Geriatrics
Background:
- Recent studies indicate a low prevalence of symptomatic late-onset hypogonadism (age-related low testosterone).
- Testosterone therapy in middle-aged and older men shows modest efficacy for specific symptoms like sexual dysfunction, mood, bone density, and anemia.
Purpose of the Study:
- To evaluate the benefits and risks of testosterone therapy in older men with age-related testosterone decline.
- To clarify the impact of testosterone therapy on prostate cancer risk and major adverse cardiovascular events.
Main Methods:
- Review of recent population studies and clinical trials on testosterone therapy.
- Analysis of efficacy in improving sexual function, mood, bone density, and anemia.
- Assessment of uncertainties regarding prostate cancer and cardiovascular risks.
Main Results:
- Syndromic prevalence of age-related low testosterone is low.
- Testosterone therapy provides modest improvements in sexual function, mood, bone density, and anemia in select older men.
- The effects on prostate cancer risk and major adverse cardiovascular events are not yet clear.
Conclusions:
- Testosterone therapy may benefit select older men with age-related testosterone decline.
- Further research, including the ongoing TRAVERSE trial, is needed to determine the risks associated with testosterone therapy, particularly concerning prostate cancer and cardiovascular events.
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