The Relationship between Testosterone Deficiency and Men's Health

Abstract

Testosterone is important in the physiology of various organs and tissues. The serum testosterone concentration gradually declines as one of the processes of aging. Thus, the concept of late-onset hypogonadism has gained increasing attention in the last few years. Reported symptoms of late-onset hypogonadism are easily recognized and include diminished sexual desire and erectile quality, particularly in nocturnal erections, changes in mood with concomitant decreases in intellectual activity and spatial orientation, fatigue, depression and anger, a decrease in lean body mass with associated decreases in muscle volume and strength, a decrease in body hair and skin alterations, and decreased bone mineral density resulting in osteoporosis. Among these various symptoms, sexual dysfunction has been the most common and necessary to treat in the field of urology. It is well known that a low serum testosterone level is associated with erectile dysfunction and hypoactive sexual libido and that testosterone replacement treatment can improve these symptoms in patients with hypogonadism. Recently, in addition to sexual dysfunction, a close relationship between metabolic syndrome, characterized by central obesity, insulin resistance, dyslipidemia, and hypertension, and late-onset hypogonadism has been highlighted by several epidemiologic studies. Several randomized control trials have shown that testosterone replacement treatment significantly decreases insulin resistance in addition to its advantage for obesity. Furthermore, metabolic syndrome is one of the major risk factors for cardiovascular disease, and a low serum testosterone level is closely related to the development of atherosclerosis. Presently, it is speculated that a low serum testosterone level may increase the risk for cardiovascular disease. Thus, testosterone is a key molecule in men's health, especially that of elderly men.

Obesity does not aggravate osteoporosis or osteoblastic insulin resistance in orchiectomized rats

“…In addition, studies indicate that a state of testosterone deficiency could impair glucose homeostasis and insulin signaling, leading to the development of obesity, insulin resistance, and type 2 diabetes mellitus (Grossmann et al 2009). Several studies have also demonstrated that a testosterone-deficient condition causes osteopenia and osteoporosis (Dupree & Dobs 2004, Tsujimura 2013). However, the effects of combined testosterone deprivation and obese insulin resistance on bone morphology, osteoblastic insulin signaling and cell survival have not yet been investigated.…”

Deterioration of chronotropic responses and heart rate recovery indices in men with erectile dysfunction

“…38 Recent large-scale cohort analyses have associated low testosterone levels with coronary artery diseases. 39,40 A more recent study of 308 men with ED showed that low testosterone levels were associated with an increased risk of CVD and that high testosterone levels could decrease this risk. 41 Previous studies have shown that EST parameters are not correlated with total testosterone and steroid hormone levels.…”

Soy Consumption with Risk of Coronary Heart Disease and Stroke: A Meta-Analysis of Observational Studies

“…However, sex-specific associations of soy foods with cardiometabolic health, with favorable effects in women and unfavorable effects in men, have been reported in a number of studies [31,32] . Other reported male-specific adverse effects of soy consumption include fibrinolysis, coagulation and lower serum testosterone levels [33][34][35][36] , and the latter has been previously associated with an increased risk of DM and metabolic syndrome [34,37,38] . Furthermore, compared with females, male subjects tended to be more likely to be smokers, and consumed more alcohol and red meats, which may diminish the benefit of soy foods consumption.…”