An international consensus document was recently published and provides guidance on the diagnosis, treatment and monitoring of late-onset hypogonadism LOH in men. The diagnosis of LOH requires biochemical and clinical components.
Controversy in defining the clinical syndrome continues due to the high prevalence of hypogonadal symptoms in the aging male population and the non-specific nature of these symptoms. Further controversy surrounds setting a lower limit of normal testosterone, the limitations of the commonly available total testosterone result in assessing some patients and the unavailability of reliable measures of bioavailable or free testosterone for general clinical use.
As with any clinical intervention testosterone treatment should be judged on a balance of risk versus benefit. The traditional benefits of testosterone on sexual function, mood, strength and quality of life remain the primary goals of treatment but possible beneficial effects on other parameters such as bone density, obesity, insulin resistance and angina are emerging and will be reviewed.
Potential concerns regarding the effects of testosterone on prostate disease, aggression and polycythaemia will also be addressed. The options available for treatment have increased in recent years with the availability of a number of testosterone preparations which can reliably produce physiological serum concentrations.
The prevalence of biochemical testosterone deficiency increases with age. This is partly due to decreasing testosterone levels associated with illness or debility but there is also convincing epidemiological data to show that serum free and total testosterone levels also fall with normal aging Harman et al ; Feldman et al The symptoms of aging include tiredness, lack of energy, reduced strength, frailty, loss of libido, decreased sexual performance depression and mood change. Men with hypogonadism experience similar symptoms.
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- Testosterone naturally decreases as a man enters a relationship and as he ages. lie in keeping her oxytocin and his testosterone level in the "good zone. .. But what happens if you're one of the 40 to 50 percent of babies. A decline in testosterone levels as men grow older is likely the result -- not the cause -- of Date: June 7, ; Source: The Endocrine Society; Summary: A decline in Two study centers in Australia recruited men over the age of 40 .
- Patients included a cohort of male veterans, aged older than 40 yr, with In an observational cohort of men with low testosterone levels, testosterone . of follow-up, at the time of death, or their last clinic visit date, whichever came first.
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Finally, we had incomplete data on follow-up testosterone levels. Treatment with phosphodiesterase-5 PDE-5 inhibitors is proven to be effective for the majority of men but some do not respond Shabsigh and Anastasiadis After multivariable adjustment including age, body mass index, testosterone level, medical morbidity, diabetes, and coronary heart disease, testosterone treatment was associated with decreased risk of death hazard ratio 0.
Increases in the amount of testosterone converted to estrogen under the action of the enzyme aromatase may also contribute to hypogonadism. This is partly due to decreasing testosterone levels associated with illness or debility but there is also convincing epidemiological data to show that serum free and total testosterone levels also fall with normal aging Harman et al ; Feldman et al Another strength of the study is that the threshold for study entry required clearly low testosterone levels.
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How long would you wait to have sexual intercourse?Male hormone replacement therapy (HRT) is gaining ground and, over the 'It's virtually impossible to say what is a healthy level of testosterone,' . This age- related decline in testosterone starts at about 35 or 40, but it's very slow. .. put on a loved-up display for cosy dinner date after confirming they've. How to gain and keep a man interested in a future with you..
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