Аndrogen deficiency in aging males in the practice of cardiologist

Abstract

Androgen deficiency in the aging man is an area of considerable debate because a gradual decline in testosterone may simply be part of the normal aging process. Аndrogen deficiency in aging males in older men is a syndrome characterized by low serum testosterone levels and clinical symptoms of hypogonadism. These symptoms include decreased libido, erectile dysfunction, decreased vitality, decreased muscle mass, increased adiposity, depressed mood, osteopenia and osteoporosis, cardiovascular disease. Hypogonadism is a common disorder in aging men with a significant percentage of men over 60 years of age having serum testosterone levels below - 15 nmol/l. This condition may result in a significant deterioration in quality of life and may adversely affect the function of multiple organ systems. Total testosterone values above 15 nmol/L usually rule out a diagnosis of hypogonadism. There are a variety of testosterone formulations available for treatment of hypogonadism. Currently available intramuscular, subdermal, transdermal, oral and buccal testosterone preparations are safe and effective. A widely held view among physicians and patients is that high testosterone levels promote the development of prostate cancer, that low testosterone levels are protective, and that testosterone replacement therapy stimulates the development of prostate cancer. There is no evidence that testosterone replacement therapy will convert sub-clinical prostatic lesions to clinically detectable prostate cancer. It is therefore very important that men with suspected hypogonadism undergo diagnostic evaluation and, if a diagnosis is confirmed, are treated and monitored. Once the diagnosis of hypogonadism is made, the benefits of testosterone replacement therapy outweigh the risks for the large majority of men.

Keywords

androgen deficiency in aging males / risk factors / cardiovascular disease / questionnaires / laboratory diagnostics / testosterone / prostate cancer / testosterone replacement therapy

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