关于EMAS的立场声明:老年男性的替代疗法
George A Kanakis1, Riccardo Pofi2, Dimitrios G Goulis3
1Department of Endocrinology & IVF Unit, Athens Naval and Veteran Affairs Hospital, Athens, Greece.
Maturitas
|October 16, 2023
概括
替代疗法 (TRT) 推给已确认低的症状老年男性,平衡好处与不确定的长期安全性. 在某些特定情况下,TRT可以改善性功能,胰岛素耐药性和生活质量.
科学领域:
- 老年医学 老年医学
- 内分泌学 在内分泌学.
- 男人的健康 男人的健康
背景情况:
- 在老年男性中,晚期发生的性腺功能低下 (LOH) 呈现出低和症状,与代谢综合征,骨密度下降和心血管风险有关.
- 虽然替代疗法 (TRT) 对年轻男性有好处,但其对老年男性的风险/益处概况仍在争论中.
研究的目的:
- 提供关于TRT在老年男性中使用LOH的更新的基于证据的声明.
- 将最近的研究成果纳入临床建议中.
主要方法:
- 对LOH和TRT最近的研究进行了全面的文献综述.
- 基于专家意见的共识发展.
主要成果:
- 对于已确认低的症状老年男性,建议对TRT进行治疗,并仔细考虑长期安全性不确定性.
- TRT可能有利于特定的疾病,如勃起功能障碍,严重的胰岛素耐药性,骨质疏松症和抑郁症状.
- 寻求生育能力的男性,患有活跃癌症,最近心血管事件或严重心力衰竭的男性,对TRT的使用是禁忌的.
结论:
- 对老年男性的TRT决策必须是个性化的,权衡感知到的好处与风险.
- 对水平,血红素,PSA和临床反应的监测至关重要.
- 对于肥胖/超重男性来说,改变生活方式对于增强内源性丸激素至关重要.
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