Andropause and Testosterone Replacement Therapy: Addressing Male Sexual Dysfunction and Aging in Men's Health

Andropause, also known as late-onset hypogonadism, is a clinical syndrome that affects men as they age, characterized by a decrease in testosterone levels and the emergence of symptoms such as sexual dysfunction, loss of muscle mass, and mood changes. Unlike menopause in women, andropause does not involve a complete cessation of gonadal function but rather a progressive decline in the function of the hypothalamic-pituitary-gonadal axis [1].

Testosterone replacement therapy (TRT) has emerged as a treatment option to mitigate the effects of andropause, particularly concerning sexual dysfunction. However, the implementation of this therapy requires a careful approach due to potential implications for men's health, including cardiovascular risks and effects on the prostate [2].

Diving Deeper into Andropause and Testosterone Replacement Therapy

Sexual dysfunction is one of the most common symptoms associated with andropause. The decrease in testosterone can lead to reduced sexual desire, erectile dysfunction, and loss of morning erections [3]. Recent studies have shown that TRT can improve these symptoms, although results may vary depending on the presence of other health conditions such as obesity and type 2 diabetes [4].

The relationship between testosterone levels and cardiovascular health remains a topic of debate. While some studies suggest that low testosterone levels are associated with an increased risk of cardiovascular diseases, the evidence regarding the effects of TRT on these risks is still limited and requires further investigation [5]. Additionally, the long-term safety of TRT remains a concern, especially in older men with high cardiovascular risk [6].

It is crucial for physicians to carefully evaluate the potential benefits and risks of TRT in each patient, considering factors such as testosterone levels, the presence of clinical symptoms, and existing comorbidities. Continuous monitoring during treatment is essential to minimize risks and maximize benefits [7].

Conclusions

Andropause represents a significant challenge in managing men's health as they age. Testosterone replacement therapy offers a viable option to address sexual dysfunction and other associated symptoms, but it must be administered with caution. Individualized assessment and continuous monitoring are fundamental to ensure that the benefits outweigh potential risks. As research progresses, it is expected that the indications and contraindications of TRT will be clarified, thereby improving the quality of life for men experiencing this syndrome.

Referencias

• [1] Testosterone deficiency and mood in aging men: pathogenic and therapeutic interactions
• [2] Testosterone therapy in men
• [3] Hypoactive sexual desire and testosterone deficiency in men
• [4] Hormonersatzbehandlung in der Andropause - Nutzen und Risiken
• [5] Andropause and the development of cardiovascular disease presentation-more than an epi-phenomenon
• [6] Andropause and testosterone deficiency: how to treat in 2012?
• [7] Andropause (androgen deficiency of the aging male): diagnosis and management

Created 13/1/2025