Age-Related Low Testosterone
Authors: E. Victor Adlin
Journal: Annals of Internal Medicine (2020)

Editorials21 January 2020Age-Related Low TestosteroneE. Victor Adlin, MDE. Victor Adlin, MDLewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania (E.V.A.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-3815 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Male hypogonadism is a syndrome of inadequate production of testosterone due to disease or injury of the hypothalamic–pituitary axis or testes. Clinical manifestations include loss of libido; erectile dysfunction; and systemic effects that may include decreased energy, sleep disturbance, depression, decreased bone mineral density, anemia, decreased muscle mass and strength, and increased body fat. In classic hypogonadism, these manifestations usually respond well to replacement of testosterone to normal levels.Because testosterone levels tend to decrease with age and many of the manifestations of hypogonadism tend to become more prevalent in aging men, a relation between these 2 phenomena has long ...References1. Nieschlag E. Late-onset hypogonadism: a concept comes of age. Andrology. 2019. [PMID: 31639279] doi:10.1111/andr.12719 CrossrefMedlineGoogle Scholar2. Basaria S, Coviello AD, Travison TG, et al. Adverse events associated with testosterone administration. N Engl J Med. 2010;363:109-22. [PMID: 20592293] doi:10.1056/NEJMoa1000485 CrossrefMedlineGoogle Scholar3. Mohler ER, Ellenberg SS, Lewis CE, et al. The effect of testosterone on cardiovascular biomarkers in the Testosterone Trials. J Clin Endocrinol Metab. 2018;103:681-8. [PMID: 29253154] doi:10.1210/jc.2017-02243 CrossrefMedlineGoogle Scholar4. Snyder PJ, Bhasin S, Cunningham GR, et al; Testosterone Trials Investigators. Effects of testosterone treatment in older men. N Engl J Med. 2016;374:611-24. [PMID: 26886521] doi:10.1056/NEJMoa1506119 CrossrefMedlineGoogle Scholar5. Qaseem A, Horwitch CA, Vijan S, et al; Clinical Guidelines Committee of the American College of Physicians. Testosterone treatment in adult men with age-related low testosterone: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2020;172:126-33. doi:10.7326/M19-0882 LinkGoogle Scholar6. Diem SJ, Greer NL, MacDonald R, et al. Efficacy and safety of testosterone treatment in men: an evidence report for a clinical practice guideline by the American College of Physicians. Ann Intern Med. 2020;172:105-18. doi:10.7326/M19-0830 LinkGoogle Scholar7. Bhasin S, Brito JP, Cunningham GR, et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2018;103:1715-44. [PMID: 29562364] doi:10.1210/jc.2018-00229 CrossrefMedlineGoogle Scholar8. Mulhall JP, Trost LW, Brannigan RE, et al. Evaluation and management of testosterone deficiency: AUA guideline. J Urol. 2018;200:423-32. [PMID: 29601923] doi:10.1016/j.juro.2018.03.115 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania (E.V.A.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-3815.Corresponding Author: E. Victor Adlin, MD, Lewis Katz School of Medicine at Temple University, 3322 North Broad Street, Philadelphia, PA 19140; e-mail, [email protected]net.This article was published at Annals.org on 7 January 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTestosterone Treatment in Adult Men With Age-Related Low Testosterone: A Clinical Guideline From the American College of Physicians Amir Qaseem , Carrie A. Horwitch , Sandeep Vijan , Itziar Etxeandia-Ikobaltzeta , Devan Kansagara , and Efficacy and Safety of Testosterone Treatment in Men: An Evidence Report for a Clinical Practice Guideline by the American College of Physicians Susan J. Diem , Nancy L. Greer , Roderick MacDonald , Lauren G. McKenzie , Philipp Dahm , Nacide Ercan-Fang , Allison Estrada , Laura S. Hemmy , Christina E. Rosebush , Howard A. Fink , and Timothy J. Wilt Metrics 21 January 2020Volume 172, Issue 2Page: 151-152KeywordsAgingBloodBone densityFollicle-stimulating hormoneHypogonadismLuteinizing hormonePhysical functioningTestesTestosteroneTreatment guidelines ePublished: 7 January 2020 Issue Published: 21 January 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...