Via practica 2/2017

Clinical importance of testosterone in the aging male from urological viewpoint

Androgen deficiency in older men (TDS – testosterone deficiency syndrome, or LOH – late onset hypogonadism) is a real clinical entity. TDS is not only the „uncomfortable health situation“, but it is a potentially serious condition associated with cardiovascular disease, diabetes, metabolic syndrome and etc. It is therefore necessary to investigate not only the serum level of testosterone in men with TDS symptoms, but also in those with abdominal obesity, diabetes mellitus, metabolic syndrome, low physical activity, and etc. Testosterone should be checked in all men with erectile dysfunction, and in those with normal erectile function, but with a low sexual desire. TDS is treated with testosterone replacement therapy (TRT), which is indicated in men with symptoms of hypogonadism, which is biochemically confirmed. Currently available formulations of testosterone are safe and effective. TRT contraindications are well defined. Prostate cancer and breast cancer are absolute contraindications of TRT. Testosterone itself has not be sufficiently „genotoxic“ to induced carcinogenesis de novo. The treating physician should have sufficient knowledge about the advantages and disadvantages of each testosterone products and the patient should have opportunity to actively cooperate in the choice of therapy.

Keywords: TDS (LOH) in older men, diagnosis, therapy, monitoring of patients