Abstract
Background: Late-Onset Hypogonadism (LOH) is defined as a clinical and biochemical syndrome associated with advancing age. It is characterized by specific symptoms and less specific manifestations due to deficiency of serum testosterone (T) levels.
Objective: This review aims to summarize the evidence related to LOH definition, diagnostic approach, and treatment to answer a clinical question: “Is Testosterone the fountain of youth for aging men?".
Methodology: MEDLINE/PubMed and institutional websites were searched for original papers, guidelines, and position statements published in the last ten years.
Results: Observational and randomized controlled studies on T replacement therapy in older men have been reported.
Discussion and Conclusion: Despite some heterogeneities regarding diagnostic definition, therapeutic target, and testosterone prescription, all guidelines agreed that male hypogonadism should be diagnosed and managed in aged men as in adulthood. However, trials assessing the efficacy of T therapy conducted for male rejuvenating are lacking; thus, T prescription for this purpose is not recommended.
Keywords: Testosterone deficiency, late-onset hypogonadism, testosterone replacement therapy, guidelines, older adults, antiaging.
Graphical Abstract
[http://dx.doi.org/10.1210/er.2004-0013] [PMID: 15901667]
[http://dx.doi.org/10.1210/er.2018-00178] [PMID: 30888401]
[http://dx.doi.org/10.1056/NEJMoa0911101] [PMID: 20554979]
[http://dx.doi.org/10.1210/jc.2007-1245] [PMID: 17698901]
[http://dx.doi.org/10.1210/er.2017-00234] [PMID: 29522088]
[http://dx.doi.org/10.1001/jama.2013.280386] [PMID: 24193080]
[http://dx.doi.org/10.1371/journal.pone.0085805] [PMID: 24489673]
[http://dx.doi.org/10.1001/jamainternmed.2013.6895] [PMID: 23939517]
[http://dx.doi.org/10.3109/13685538.2015.1004049] [PMID: 25657080]
[http://dx.doi.org/10.1111/jsm.12952] [PMID: 26081680]
[http://dx.doi.org/10.1210/jc.2018-00229] [PMID: 29562364]
[http://dx.doi.org/10.1016/j.juro.2018.03.115] [PMID: 29601923]
[http://dx.doi.org/10.1016/j.jsxm.2017.10.067] [PMID: 29198507]
[http://dx.doi.org/10.1503/cmaj.150033] [PMID: 26504097]
[http://dx.doi.org/10.5694/mja16.00393] [PMID: 27510348]
[http://dx.doi.org/10.5694/mja16.00448] [PMID: 27581270]
[http://dx.doi.org/10.1111/andr.12770] [PMID: 32026626]
[http://dx.doi.org/10.1210/jcem-55-4-676] [PMID: 6809780]
[http://dx.doi.org/10.1210/jcem.75.3.1517359] [PMID: 1517359]
[http://dx.doi.org/10.1210/jcem.86.2.7219] [PMID: 11158037]
[http://dx.doi.org/10.1210/jc.2003-031719] [PMID: 15579737]
[http://dx.doi.org/10.1111/andr.12850] [PMID: 32593233]
[http://dx.doi.org/10.3109/13685539909003173]
[http://dx.doi.org/10.1053/meta.2000.8625] [PMID: 11016912]
[http://dx.doi.org/10.1046/j.1365-2265.2000.01152.x] [PMID: 11155092]
[http://dx.doi.org/10.1210/jc.2017-02360] [PMID: 29618085]
[http://dx.doi.org/10.1111/j.1743-6109.2006.00262.x] [PMID: 16839327]
[http://dx.doi.org/10.1210/jc.2006-0401] [PMID: 16926258]
[PMID: 10999822]
[http://dx.doi.org/10.4103/aja.aja_61_19] [PMID: 31249270]
[http://dx.doi.org/10.1016/j.jsxm.2016.04.068] [PMID: 27209182]
[http://dx.doi.org/10.1111/j.1365-2265.2007.02843.x] [PMID: 17547693]
[http://dx.doi.org/10.1002/j.1939-4640.1989.tb00120.x] [PMID: 2592266]
[http://dx.doi.org/10.1111/j.1365-2265.2007.02976.x] [PMID: 18052942]
[http://dx.doi.org/10.1210/jc.2009-2435] [PMID: 20668046]
[http://dx.doi.org/10.1210/jc.2008-1902] [PMID: 19088162]
[http://dx.doi.org/10.1210/jc.2007-0117] [PMID: 17579205]
[http://dx.doi.org/10.1210/jc.2004-1025] [PMID: 15755867]
[http://dx.doi.org/10.1016/j.jsxm.2016.07.001] [PMID: 27555502]
[http://dx.doi.org/10.1530/EJE-08-0601] [PMID: 18955511]
[http://dx.doi.org/10.1097/MED.0b013e328353732f] [PMID: 22531107]
[http://dx.doi.org/10.1016/j.jsxm.2019.11.270] [PMID: 31928918]
[http://dx.doi.org/10.1177/1740774514524032] [PMID: 24686158]
[http://dx.doi.org/10.1210/jcem-66-1-62] [PMID: 2891722]
[http://dx.doi.org/10.1530/EJE-15-0338] [PMID: 25877990]
[http://dx.doi.org/10.1016/j.steroids.2009.01.004] [PMID: 19428438]
[http://dx.doi.org/10.1530/EJE-11-1051] [PMID: 22423144]
[http://dx.doi.org/10.1210/jc.2016-2935] [PMID: 28324103]
[http://dx.doi.org/10.1111/j.1743-6109.2011.02497.x] [PMID: 21995803]
[http://dx.doi.org/10.1210/jc.2006-1864] [PMID: 17090633]
[http://dx.doi.org/10.1210/jc.2012-2265] [PMID: 22977273]
[http://dx.doi.org/10.1210/jc.2010-3012] [PMID: 21697255]
[http://dx.doi.org/10.1530/eje.0.1510241] [PMID: 15296480]
[http://dx.doi.org/10.1210/jc.2015-4106] [PMID: 26909800]
[http://dx.doi.org/10.3390/geriatrics5040076] [PMID: 33081371]
[http://dx.doi.org/10.1111/andr.12901] [PMID: 32902162]
[http://dx.doi.org/10.1210/jc.2014-4434] [PMID: 26158605]
[http://dx.doi.org/10.2174/1872214810999160603213743] [PMID: 27981914]
[http://dx.doi.org/10.1001/jamapsychiatry.2018.2734] [PMID: 30427999]
[http://dx.doi.org/10.1097/WNN.0000000000000104] [PMID: 27662450]
[http://dx.doi.org/10.1056/NEJMoa1506119] [PMID: 26886521]
[http://dx.doi.org/10.1111/andr.12470] [PMID: 29499097]
[http://dx.doi.org/10.1159/000494900] [PMID: 31499499]
[http://dx.doi.org/10.1530/EJE-15-0262] [PMID: 26537862]
[http://dx.doi.org/10.1056/NEJMoa1000485] [PMID: 20592293]
[http://dx.doi.org/10.1186/1741-7015-11-108] [PMID: 23597181]
[http://dx.doi.org/10.1136/jim-2017-000411] [PMID: 28495861]
[http://dx.doi.org/10.2174/138161211796197160] [PMID: 21521164]
[http://dx.doi.org/10.1210/jc.2019-00806] [PMID: 31504596]
[http://dx.doi.org/10.1210/js.2019-00151] [PMID: 31528824]
[http://dx.doi.org/10.1016/j.ijcard.2015.02.055] [PMID: 25755056]
[http://dx.doi.org/10.2174/1871530311313010011] [PMID: 23369141]
[http://dx.doi.org/10.1007/s11739-018-1844-8] [PMID: 29619769]
[http://dx.doi.org/10.1002/ehf2.12520] [PMID: 31696666]
[http://dx.doi.org/10.2174/1871530311313010015] [PMID: 23369145]
[http://dx.doi.org/10.1007/s40618-017-0619-9] [PMID: 28258556]
[http://dx.doi.org/10.2174/1871530318666180703160250] [PMID: 29972105]
[http://dx.doi.org/10.1210/jc.2016-3580] [PMID: 28359097]
[http://dx.doi.org/10.1111/andr.12754] [PMID: 31919991]
[http://dx.doi.org/10.5534/wjmh.190061] [PMID: 31496147]
[http://dx.doi.org/10.3390/nu11122975] [PMID: 31817436]
[http://dx.doi.org/10.1371/journal.pone.0183369] [PMID: 28886024]
[http://dx.doi.org/10.1155/2020/9649838] [PMID: 32411230]
[http://dx.doi.org/10.1111/cen.14122] [PMID: 31677181]
[http://dx.doi.org/10.1111/andr.12099] [PMID: 26447645]
[http://dx.doi.org/10.2174/1871530319666190507125847] [PMID: 31670618]
[http://dx.doi.org/10.1111/andr.12836] [PMID: 32524732]
[http://dx.doi.org/10.2174/1871530321666210101123801] [PMID: 33388025]
[http://dx.doi.org/10.1007/s12020-020-02444-9] [PMID: 32779091]
[http://dx.doi.org/10.3390/cells10113114] [PMID: 34831334]
[http://dx.doi.org/10.1093/gerona/gly082] [PMID: 29688289]
[http://dx.doi.org/10.1016/j.mad.2021.111519] [PMID: 34139215]
[http://dx.doi.org/10.1111/and.13034] [PMID: 29740839]
[http://dx.doi.org/10.1016/j.cmet.2016.09.013] [PMID: 28068222]