[Should older men be treated with testosterone?].
BACKGROUND
Male hypogonadism is a clinical situation characterised by a low serum testosterone level in combination with a diversity of symptoms and signs such as reduced libido and vitality, decreased muscle mass, increased fat mass and depression. Similar symptoms in combination with subnormal testosterone levels are seen in some elderly men. Several publications have suggested that testosterone treatment in hypogonadal men may have beneficial effects, but it is still uncertain whether testosterone substitution in the aging man is indicated. Despite this uncertainty the sale of testosterone have increased enormously over the last few years, hence it seems important to discuss what we now know about such treatment.


METHODS
Review of recent literature studying testosterone substitution in older men.


CONCLUSIONS
The result from placebo-controlled studies of testosterone substitution in elderly men differ substantially, but it seems to improve, among other things, bone mineral density, body composition, perception of physical strength, and maybe libido. In the short term there have been few problems or complications with testosterone treatment, but effects on the cardiovascular system and the prostate over the long term remain uncertain. Before any general recommendation could be given, big prospective studies have to be performed. Treatment should, however, be considered in men with testosterone in the hypogonadal range accompanied by clinical symptoms. Treatment needs to be individualized and should preferably be initiated by specialists in andrology, endocrinology or urology.
Svartberg
Johan
J
Endokrinologisk seksjon, Medisinsk avdeling B, Universitetssykehuset Nord-Norge, 9038 Tromsø. johan.svartberg@unn.no
D000367:Age Factors; D000728:Androgens / Q000008:administration & dosage* / Q000009:adverse effects; D001823:Body Composition / Q000187:drug effects; D015519:Bone Density / Q000187:drug effects; D006801:Humans; D007006:Hypogonadism / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D019529:Sexuality / Q000187:drug effects; D013739:Testosterone / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood
D000728:Androgens; D013739:Testosterone