The effect of testosterone supplementation on BMD and the risk of falls or fracture remains inconclusive .
However , supplementation may benefit patients in the areas of sexual function and quality of life without increasing the risk of cardiovascular events , all-cause mortality , or prostatic events .
Testosterone deficiency ( TD ) may induce a series of clinical symptoms .
Studies have shown that testosterone supplementation may prevent these unfavourable symptoms and improve patients ’ quality of life .
Given the conflicting findings across studies , this systematic review aims to evaluate the effects and risks associated with testosterone supplementation in middle-aged or aging males with TD .
Effects of transdermal testosterone gel or an aromatase inhibitor on serum concentration and pulsatility of growth hormone in older men with age-related low testosterone.
Growth hormone is the major regulator of growth and body composition . Pulsatile GH secretion declines exponentially with age . Testosterone replacement is being increasingly offered to older men with age-related low testosterone .  Testosterone administration has been shown to stimulate GH secretion . However , little is known about the effect of testosterone aromatization to estradiol on GH pulsatility and its impact on IGF-1 in older men . OBJECTIVE This r and omized controlled proof-of-concept trial investigated the relative effects of testosterone and estradiol on GH pulsatility and IGF-1 in older men with low testosterone . DESIGN Thirty-seven men , ≥65years with total testosterone < 350ng/dL were r and omized to 5 g transdermal testosterone gel ( TT ) , 1 mg oral aromatase inhibitor ( AI ) or placebo daily for 12months . Primary outcome was deconvolution and approximate entropy analyses of pulsatile including basal and entropic modes of secretion performed at baseline and 3months . Secondary outcomes included IGF-1 evaluated at baseline , 3 and 6months . RESULTS At 3months , mean GH and in IGF-1 were similar between the three groups . At 6months , IGF-1 significantly increased by Δ 15.3±10.3ng/ml in the TT-group compared to placebo ( P=0.03 ) . Both intervention groups significantly increased GH pulse frequency ( TT-group , P=0.04 ; AI-group , P=0.05 ) compared to placebo . The GH secretory-burst mode ( duration ) significantly decreased in the TT-group ( P=0.0018 ) compared to placebo while it remained unchanged in the AI-group ( P=0.059 ) . CONCLUSIONS In older men  , testosterone  increases GH pulse frequency while the aromatization to estradiol is involved in the rise of IGF-1 levels
The effect of testosterone supplementation on BMD and the risk of falls or fracture remains inconclusive .
However , supplementation may benefit patients in the areas of sexual function and quality of life without increasing the risk of cardiovascular events , all-cause mortality , or prostatic events .
Testosterone deficiency ( TD ) may induce a series of clinical symptoms .
Studies have shown that testosterone supplementation may prevent these unfavourable symptoms and improve patients ’ quality of life .
Given the conflicting findings across studies , this systematic review aims to evaluate the effects and risks associated with testosterone supplementation in middle-aged or aging males with TD .