Late-onset Hypogonadism and Testosterone Therapy – A Summary of Guidelines from the American Urological Association and the European Association of Urology

Abstract

Men with low serum testosterone and symptoms of androgen deficiency may be diagnosed with testosterone deficiency. This condition is associated with metabolic syndrome and cardiovascular disease. The benefits (eg, improvement in sexual function) and risks (eg, prostate cancer and cardiovascular disease) of testosterone therapy are controversial. The American Urological Association and European Association of Urology guidelines on testosterone therapy differ on several points of management, likely reflecting the ambiguities surrounding testosterone therapy in practice. This paper summarizes both guidelines with a focus on the differences between the two sets of guidelines. Patient summary: The benefits and risks of testosterone therapy are controversial, as reflected in the European Association of Urology and American Urological Association guidelines that differ on several points of management.

Effect of serum total testosterone and its relationship with other laboratory parameters on the prognosis of coronavirus disease 2019 (COVID-19) in SARS-CoV-2 infected male patients: a cohort study

“…Late-onset hypogonadism or testosterone deficiency may result in significant detriment to quality of life, and adversely affect the function of multiple organ systems [4]. In a systematic review and metaanalysis, consisting of the 21 studies, Araujo et al [6] demonstrated that difference in the means of the top and bottom third of the standard normal distribution in total testosterone was associated with 35 and 25% increased risk of all-cause and cardiovascular disease mortality, respectively.…”

“…Testosterone is the principal male sex hormone, and decreases on average by 0.8-2% per year after the age of 40 years. The prevalence of male hypogonadism has been ranged from 2.1 to 9.5% in men aged 40-70 years [4][5][6]. Its rate significantly increases, ranging 10-80% in several morbid diseases [4][5][6].…”

“…The prevalence of male hypogonadism has been ranged from 2.1 to 9.5% in men aged 40-70 years [4][5][6]. Its rate significantly increases, ranging 10-80% in several morbid diseases [4][5][6]. Male late-onset hypogonadism has been reported as a risk factor for diabetes, chronic obstructive pulmonary disease, metabolic syndrome, dyslipidemia, thrombotic and cardiovascular disease, leading to increased mortality in the general population [6][7][8][9][10].…”

Lipid accumulation product and late-onset hypogonadism in middle-aged and elderly men: results from a cross-sectional study in China

“…Late-onset hypogonadism (LOH) is associated with advancing age and is characterised by symptoms of androgen deficiency and low serum testosterone 1. Hypogonadism with clinical symptoms can lead to decline in exercise tolerance and muscle mass and an attenuation of bone strength, which may significantly reduce quality of life 2.…”

Systemic effects of the hormonal treatment of male hypogonadism with preliminary indications for the management of COVID-19 patients

“…These results don’t support a protective role of TRT towards patients with a history of PCa, but encourage broaden research in this way. 91 , 94 …”