Urology

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Determining when men need testosterone
The Clinical Advisor, 07/17/09

Quallich S - In middle-aged men, testosterone levels decrease 1%-2% yearly with advancing age. Studies suggest that approximately 20% of men in their 60s and 50% of those in their 80s have low serum testosterone levels. Obesity, metabolic syndrome, type 2 diabetes mellitus, and hypertension may increase the risk of hypogonadism. Men with symptomatic testosterone deficiency and a total testosterone level <300 may be candidates for testosterone replacement therapy, although no specific recommendations have been established. The typical treatment candidate has a validated low total testosterone level and consistent symptoms of testosterone deficiency, especially sexual function complaints. The benefits of testosterone therapy in men with testosterone deficiency include improvements in libido, sexual function, and quality of life; maintenance of cognitive function; prevention of bone mineral density (BMD) loss and osteoporosis; and possibly reductions in risk factors for cardiovascular disease. In older men with low-normal serum testosterone levels, recent evidence suggests that testosterone therapy increases lean body mass but has no beneficial effects on functional mobility, muscle strength, cognitive function, or BMD.

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