What are the benefits and harms of testosterone replacement therapy in men with age-related low testosterone?

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Mikaela Alger ◽  
Natalia A. Luera ◽  
Rachel Weiner
Keyword(s):  
Replacement Therapy ◽  
Testosterone Replacement ◽  
Testosterone Replacement Therapy ◽  
Age Related ◽  
Low Testosterone

scholarly journals Perspectives for metabolomics in testosterone replacement therapy

2012 ◽  
Vol 215 (1) ◽  
pp. 3-16 ◽  
Author(s):  
Robin Haring
Keyword(s):  
Replacement Therapy ◽  
Biomarker Discovery ◽  
Clinical Symptoms ◽  
Late Onset ◽  
Disease Diagnosis ◽  
Deficiency Syndrome ◽  
Testosterone Replacement ◽  
Testosterone Replacement Therapy ◽  
Age Related ◽  
Pubmed Database

Testosterone is the major circulating androgen in men but exhibits an age-related decline in the ageing male. Late-onset hypogonadism or androgen deficiency syndrome (ADS) is a ‘syndromic’ disorder including both a persistent low testosterone serum concentration and major clinical symptoms, including erectile dysfunction, low libido, decreased muscle mass and strength, increased body fat, decreased vitality or depressed mood. Given its unspecific symptoms, treatment goals and monitoring parameters, this review will outline the various uncertainties concerning the diagnosis, therapy and monitoring of ADS to date. Literature was identified primarily through searches for specific investigators in the PubMed database. No date or language limits were applied in the literature search for the present review. The current state of research, showing that metabolomics is starting to have an impact not only on disease diagnosis and prognosis but also on drug treatment efficacy and safety monitoring, will be presented, and the application of metabolomics to improve the clinical management of ADS will be discussed. Finally, the scientific opportunities presented by metabolomics and other -omics as novel and promising tools for biomarker discovery and individualised testosterone replacement therapy in men will be explored.

Cardiovascular and Cerebrovascular Safety of Testosterone Replacement Therapy Among Aging Men with Low Testosterone Levels: A Cohort Study

2019 ◽  
Vol 132 (9) ◽  
pp. 1069-1077.e4 ◽  
Author(s):  
Simone Y. Loo ◽  
Laurent Azoulay ◽  
Rui Nie ◽  
Sophie Dell’Aniello ◽  
Oriana Hoi Yun Yu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Replacement Therapy ◽  
Testosterone Replacement ◽  
Testosterone Replacement Therapy ◽  
Testosterone Levels ◽  
Aging Men ◽  
Low Testosterone

scholarly journals Testosterone Deficiency, Cardiac Health, and Older Men

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
G. Hackett ◽  
M. Kirby ◽  
A. J. Sinclair
Keyword(s):  
Type 2 Diabetes ◽  
Replacement Therapy ◽  
Risk Groups ◽  
Testosterone Replacement ◽  
Current Evidence ◽  
Testosterone Replacement Therapy ◽  
Testosterone Deficiency ◽  
Low Testosterone ◽  
Low Levels

Low levels of testosterone are manifested by erectile dysfunction, reduced sexual desire, and loss of morning erections with increasing numbers of men are being diagnosed and require treatment. The prevalence rates of testosterone deficiency vary according to different studies but may be as high as 40% in populations of patients with type 2 diabetes. There is increasing evidence that testosterone deficiency is associated with increased cardiovascular and all-cause mortality. Screening for low testosterone is recommended in a number of high risk groups including those with type 2 diabetes and metabolic syndrome. There are recent data to suggest that testosterone replacement therapy may reduce cardiovascular mortality as well as improving multiple surrogate markers for cardiovascular events. Specific clinical trials of testosterone replacement therapy are needed in selected populations but in the meantime we must treat patients based on the best current evidence.

Testosterone replacement in normal and pathologic prostate

2012 ◽  
Vol 11 (3) ◽  
Author(s):  
Mohit Khera
Keyword(s):  
Prostate Cancer ◽  
Benign Prostatic Hyperplasia ◽  
Replacement Therapy ◽  
Rapid Growth ◽  
Prostatic Hyperplasia ◽  
Testosterone Replacement ◽  
Testosterone Replacement Therapy ◽  
The Past ◽  
The Usa ◽  
Low Testosterone

AbstractThe testosterone replacement therapy (TRT) market has grown rapidly over the past 5 years. Exogenous testosterone in various forms is now the fastest-growing medication prescribed in the USA. From 2005 to 2009, spending on testosterone jumped 115.5%, and the number of prescriptions filled increased 64.5%. One of the main reasons for this rapid growth in the TRT market is decreased concern that TRT can lead to prostate cancer. Other reasons are decreased concerns that testosterone can lead to worsening of benign prostatic hyperplasia (BPH) symptoms. In fact, recent studies suggest that TRT may improve BPH symptoms. Although there have been marked increases in the treatment of low testosterone, lingering concerns about prostate cancer have hindered progress. There are many theories, such as the prostate saturation theory, that may help us understand why testosterone may be safely administered in men with hypogonadism with normal and pathologic prostatic disease.

scholarly journals Why Is Androgen Replacement in Males Controversial?

2011 ◽  
Vol 96 (1) ◽  
pp. 38-52 ◽  
Author(s):  
Glenn R. Cunningham ◽  
Shivani M. Toma
Keyword(s):  
Clinical Trials ◽  
Replacement Therapy ◽  
Evidence Synthesis ◽  
Epidemiological Studies ◽  
Testosterone Replacement ◽  
Testosterone Replacement Therapy ◽  
Androgen Deficiency ◽  
Testosterone Levels ◽  
Potential Risks ◽  
Low Testosterone

Context: Symptoms and signs consistent with androgen deficiency and low testosterone levels are recognized frequently in clinical practice. Recent population-based epidemiological studies indicate that low testosterone levels in men are associated with increased morbidity and mortality. The clinician must be able to counsel patients to help them determine whether testosterone replacement therapy is appropriate for them. Evidence Acquisition: The authors have conducted a literature search in PubMed, and we have reviewed references in the multiple systematic reviews and meta-analyses that have been published on this topic. Evidence Synthesis: We have attempted to provide the reader with an appreciation of the evidence that can be used to support the diagnosis of androgen deficiency, the efficacy of treatment, the potential risks of treatment, the therapeutic options, and the recommendations for monitoring treatment. Conclusions: We think that published clinical experience justifies testosterone replacement therapy in males who have not initiated puberty by age 14 and in males with low testosterone levels due to classical diseases of the hypothalamic-pituitary-gonadal axis. The benefit:risk ratio is less certain in older men and in those with chronic diseases associated with low testosterone levels. The decision to treat in this setting is much more controversial because there are few large clinical trials that have demonstrated efficacy and no large clinical trials that have determined potential risks of increasing the incidence of clinical prostate cancers or cardiovascular events. We provide a critical review of the evidence that supports treatment and potential risks and ways to reduce the risks if the physician and patient elect testosterone replacement.

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