Late-onset hypogonadism: etiology, clinical features, diagnostics, treatment

Abstract

In a critical review of the literature current data concerning etiology, clinical features, diagnostics, treatment of late-onset hypogonadism (LOH) are given. LOH is a multidisciplinary problem, because a patient with LOH can have osteoporosis, anemia, depression, obesity, diabetes mellitus, erectile dysfunction. Sometimes it is hard to realize that all this complaints are symptoms of LOH. LOH has a negative impact on a patient,s quality of life and it,s impossible to help without androgen replacement therapy. Furthermore doctors often have doubts about testosterone replacement therapy safety because of lack of accurate information. In a convenient for medical practitioners form clinical and laboratory diagnostic criteria of LOH are presented together with formulas for conversion from one measurement unit of main sex hormones into another. Based on latest ISSAM guidelines (International Society for the Study of the Aging Male) modern treatment options of LOH are summarized, full information about available testosterone preparations (oral, transdermal, injectable) with comparative analysis of advantages and disadvantages of each is given. A full description of indications and contraindications for androgen replacement treatment is presented, also treatment regimen and medical supervision algorithm during treatment are described.

Keywords

• late-onset hypogonadism
• testosterone
• luteinizing hormone
• sex-steroid binding globulin
• erectile dysfunction
• hypogonadism treatment
• androgen replacement therapy
• quality of life
• safety