Investigation, treatment and monitoring of late-onset hypogonadism in males

TLDR

The aging male population is growing, and studies show testosterone levels decline with age, leaving many men over 60 with sub‑normal serum testosterone. The study aims to determine whether testosterone therapy benefits older hypogonadal men and to identify associated risks, especially regarding prostate and cardiovascular outcomes and patient‑reported functional improvements. A comprehensive review by the Institute of Medicine summarizes current evidence on testosterone treatment in older men.

Abstract

Demographic data clearly demonstrate that the percentage of the population in the older age group is increasing. Androgen deficiency in the aging male has become a topic of increasing interest and debate throughout the world. Cross-sectional and longitudinal data indicate that the testosterone falls progressively with age and that a significant percentage of men over the age of 60 years have serum testosterone levels that are below the lower limits of young adult (age 20–30 years) men (1–4). The principal questions raised by these observations are whether older hypogonadal men will benefit from testosterone treatment and what will be the risks associated with such intervention. This has been comprehensively reviewed and summarized by the Institute of Medicine in ‘Testosterone and Aging: Clinical Research Directions’ (5). Long-term data on the effects of testosterone treatment in the older population are limited mainly to effects on body composition and bone mass (6–11). Key questions of the effects of testosterone on patient reported outcomes and functional benefits that may retard physical or mental frailty of the elderly or improve the quality of life are not yet available. Specific risk data on the prostate and cardiovascular systems are needed.