Purpose of review
Numerous publications of recent years have focused on androgen decline in elderly men. Diagnosis, clinical significance and treatment remain highly controversial issues. The present review aims at a critical overview of the topic with particular attention on recent studies and informative reviews.
It is now well established that aging in men is accompanied by a progressive decline of testosterone levels. Associations with clinical signs and symptoms are usually weak and most study areas have been on bone metabolism, body composition, sexual function, cardiovascular risk factors, mood, depression and cognitive function. The main focus of intervention studies has been on body composition, bone metabolism, sexual function and indices related to quality of life, besides safety parameters. These studies have included a limited number of men, are of relatively short duration, and measure intermediary clinical endpoints.
To date, intervention studies have included too few partially androgen deficient patients and were of too short duration to provide reliable data on long-term risks versus benefits of androgen replacement therapy in elderly men. In this context, treatment should be reserved for elderly men with clear hypogonadism.