scholarly journals Testosterone Therapy for Men With Age-Related Low Testosterone: Tempest in a Teacup

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 471-471
Author(s):  
Shehzad Basaria
Keyword(s):  
Cardiovascular Health ◽  
Serum Testosterone ◽  
Older Men ◽  
Normal Range ◽  
Testosterone Levels ◽  
Age Related ◽  
Calcified Plaque ◽  
Testosterone Gel ◽  
Physical Dysfunction ◽  
Low Testosterone

Abstract Serum testosterone concentrations decrease in men with age, but benefits and risks of raising testosterone levels in older men remain controversial. In the T-Trials, a total of 790 men, age 65 and older, with a serum testosterone concentration of < 275 ng/dL and symptoms of sexual dysfunction, fatigue or physical dysfunction were randomized to either testosterone gel or placebo gel for 1 year. Treatment in the testosterone arm increased serum testosterone levels to the mid-normal range for young men. Testosterone replacement was associated with a significant increase in sexual activity (p<0.001), libido and erectile function. In contrast, there was no improvement in vitality or physical function. Adverse findings included increases in non-calcified plaque formation and a higher rate of prostate events. In sum, testosterone treatment in older men was associated with modest benefits, while the risk on prostate and cardiovascular health remain unclear.

scholarly journals Testosterone and cognitive function: current clinical evidence of a relationship

2006 ◽  
Vol 155 (6) ◽  
pp. 773-781 ◽  
Author(s):  
Olivier Beauchet
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cognitive Ability ◽  
Cognitive Dysfunction ◽  
Clinical Evidence ◽  
Serum Testosterone ◽  
Older Men ◽  
Testosterone Levels ◽  
Testosterone Substitution ◽  
Low Testosterone

Background: Testosterone levels decline as men age, as does cognitive function. Whether there is more than a temporal relationship between testosterone and cognitive function is unclear. Chemical castration studies in men with prostate cancer suggest that low serum testosterone may be associated with cognitive dysfunction. Low testosterone levels have also been observed in patients with Alzheimer’s disease (AD) and mild cognitive impairment (MCI). This paper reviews the current clinical evidence of the relationship between serum testosterone levels and cognitive function in older men. Methods: A systematic literature search was conducted using PubMed and EMBASE to identify clinical studies and relevant reviews that evaluated cognitive function and endogenous testosterone levels or the effects of testosterone substitution in older men. Results: Low levels of endogenous testosterone in healthy older men may be associated with poor performance on at least some cognitive tests. The results of randomized, placebo-controlled studies have been mixed, but generally indicate that testosterone substitution may have moderate positive effects on selective cognitive domains (e.g. spatial ability) in older men with and without hypogonadism. Similar results have been found in studies in patients with existing AD or MCI. Conclusions: Low endogenous levels of testosterone may be related to reduced cognitive ability, and testosterone substitution may improve some aspects of cognitive ability. Measurement of serum testosterone should be considered in older men with cognitive dysfunction. For men with both cognitive impairment and low testosterone, testosterone substitution may be considered. Large, long-term studies evaluating the effects of testosterone substitution on cognitive function in older men are warranted.

scholarly journals 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

Metabolism ◽  
2017 ◽  
Vol 69 ◽  
pp. 143-147 ◽  
Author(s):  
Jenny Pena Dias ◽  
Johannes D. Veldhuis ◽  
Olga Carlson ◽  
Michelle Shardell ◽  
Chee W. Chia ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Serum Concentration ◽  
Aromatase Inhibitor ◽  
Older Men ◽  
Age Related ◽  
Testosterone Gel ◽  
Low Testosterone

scholarly journals Differences in the Apparent Metabolic Clearance Rate of Testosterone in Young and Older Men with Gonadotropin Suppression Receiving Graded Doses of Testosterone

2006 ◽  
Vol 91 (11) ◽  
pp. 4669-4675 ◽  
Author(s):  
Andrea D. Coviello ◽  
Kishore Lakshman ◽  
Norman A. Mazer ◽  
Shalender Bhasin
Keyword(s):  
Lean Body Mass ◽  
Body Mass ◽  
Young Men ◽  
Serum Testosterone ◽  
Older Men ◽  
Total Testosterone ◽  
Metabolic Clearance ◽  
Clearance Rates ◽  
Testosterone Levels ◽  
Age Related

Abstract Background: Recently we found that testosterone levels are higher in older men than young men receiving exogenous testosterone. We hypothesized that older men have lower apparent testosterone metabolic clearance rates (aMCR-T) that contribute to higher testosterone levels. Objective: The objective of the study was to compare aMCR-T in older and young men and identify predictors of aMCR-T. Methods: Sixty-one younger (19–35 yr) and 60 older (59–75 yr) men were given a monthly GnRH agonist and weekly testosterone enanthate (TE) (25, 50, 125, 300, or 600 mg) for 5 months. Estimated aMCR-T was calculated from the amount of TE delivered weekly and trough serum testosterone concentrations, corrected for real-time absorption kinetics from the im testosterone depot. Results: Older men had lower total (316 ± 13 vs. 585 ± 26 ng/dl, P < 0.00001) and free testosterone (4 ± 0.1 vs. 6 ± 0.3 ng/dl, P < 0.00001) and higher SHBG (52 ± 3 vs. 33 ± 2 nmol/liter, P < 0.00001) than younger men at baseline. Total and free testosterones increased with TE dose and were higher in older men than young men in the 125-, 300-, and 600-mg dose groups. aMCR-T was lower in older men than young men (1390 ± 69 vs. 1821 ± 102 liter/d, P = 0.006). aMCR-T correlated negatively with age (P = 0.0007), SHBG (P = 0.046), and total testosterone during treatment (P = 0.02) and percent body fat at baseline (P = 0.01) and during treatment (P = 0.004). aMCR-T correlated positively with lean body mass at baseline (P = 0.03) and during treatment (P = 0.01). In multiple regression models, significant predictors of aMCR-T included lean body mass (P = 0.008), percent fat mass (P = 0.009), and SHBG (P = 0.001). Conclusions: Higher testosterone levels in older men receiving TE were associated with an age-related decrease in apparent testosterone metabolic clearance rates. Body composition and SHBG were significant predictors of aMCR-T.

Benefits and Risks of Testosterone Treatment in Men with Age-Related Decline in Testosterone

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Marcelo Rodrigues dos Santos ◽  
Shalender Bhasin
Keyword(s):  
Prostate Cancer Risk ◽  
Older Men ◽  
Annual Review ◽  
Publication Date ◽  
Long Term Effects ◽  
Endocrine Society ◽  
Testosterone Treatment ◽  
Testosterone Levels ◽  
Age Related ◽  
Low Testosterone

The substantial increase in life expectancy of men has focused growing attention on quality-of-life issues associated with reproductive aging. Serum total and free testosterone levels in men, after reaching a peak in the second and third decade of life, decline gradually with advancing age. The trajectory of age-related decline is affected by comorbid conditions, adiposity, medications, and genetic factors. Testosterone treatment of older men with low testosterone levels improves overall sexual activity, sexual desire, and erectile function; improves areal and volumetric bone density, as well as estimated bone strength in the spine and the hip; corrects unexplained anemia of aging; increases skeletal muscle mass, strength and power, self-reported mobility, and some measures of physical function; and modestly improves depressive symptoms. The long-term effects of testosterone on major cardiovascular events and prostate cancer risk remain unclear. The Endocrine Society recommends against testosterone therapy of all older men with low testosterone levels but suggests consideration of treatment on an individualized basis in men who have consistently low testosterone levels and symptoms or conditions suggestive of testosterone deficiency. Expected final online publication date for the Annual Review of Medicine, Volume 72 is January 27, 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Low testosterone levels and decline in physical performance and muscle strength in older men: findings from two prospective cohort studies

2008 ◽  
Vol 68 (1) ◽  
pp. 42-50 ◽  
Author(s):  
Laura A. Schaap ◽  
Saskia M. F. Pluijm ◽  
Dorly J. H. Deeg ◽  
Brenda W. Penninx ◽  
Barbara J. Nicklas ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Cohort Studies ◽  
Physical Performance ◽  
Prospective Cohort ◽  
Older Men ◽  
Testosterone Levels ◽  
Prospective Cohort Studies ◽  
Low Testosterone

Age-Related Androgen Deficiency and Type 2 Diabetes

2011 ◽  
Vol 24 (3) ◽  
pp. 316-322 ◽  
Author(s):  
Gina J. Ryan ◽  
Lynetta J. Jobe
Keyword(s):  
Type 2 Diabetes ◽  
Hypogonadotropic Hypogonadism ◽  
Treatment Options ◽  
Mineral Density ◽  
Testosterone Levels ◽  
Know How ◽  
Age Related ◽  
Appropriate Therapy ◽  
Low Testosterone

There is a higher prevalence of low testosterone levels in males with type 2 diabetes compared to those without. Additionally, there is evidence that low testosterone levels may predict the development of type 2 diabetes. Symptoms of hypogonadism include decreased libido, decreased bone mineral density (BMD), and decreased lean muscle mass. The majority of the published cases in men with diabetes were attributed to age-related idiopathic hypogonadotropic hypogonadism. This paper reviews the link between type 2 diabetes and age-related hypogonadism and the treatment options for hypogonadism. Pharmacists who provide care for males with diabetes should be aware of the increased incidence of hypogonadism, know how to screen for it, and be able to recommend appropriate therapy.

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