The treatment of late-onset hypogonadism
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Date
2014
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Abstract
Late-onset hypogonadism (LOH) in aging men is a clinical and biochemical syndrome caused by an age-re -lated decline in testosterone. Despite published in guidelines and recommendations, uncertainty surroundsthe profle of clinical symptoms as well as the biochemical threshold of diagnosis. The only evidence-basedtreatment of late-onset hypogonadism is testosterone replacement therapy. The actual available evidenceof the long-term risks and outcomes of testosterone-replacement therapy remains very limited, and care -fully designed placebo-controlled trials of testosterone administration to assess the risks and benefts ofsuch a therapy are required. Until such evidence is available, testosterone treatment should be restricted toelderly men with very low testosterone levels in the presence of clinical symptoms, and the advantages anddisadvantages need to be accurately assessed. Careful monitoring of potential side effects is necessary. Thepurpose of this review is to discuss what is known and what remains unclear with respect to the benefts andrisks of testosterone replacement treatment.