Late-onset hypogonadism: Clinical evidence, biological aspects and evolutionary considerations

Research output: Contribution to journalReview articleContributedpeer-review

Contributors

  • Nikolai Jaschke - , University Hospital Carl Gustav Carus Dresden (Author)
  • Andrew Wang - , Yale University (Author)
  • Lorenz C Hofbauer - , University Hospital Carl Gustav Carus Dresden (Author)
  • Martina Rauner - , University Hospital Carl Gustav Carus Dresden (Author)
  • Tilman D Rachner - , University Hospital Carl Gustav Carus Dresden (Author)

Abstract

The growing life expectancy in modern societies has raised scientific interest in identifying medical interventions to alleviate age-associated pathologies such as vascular calcification, cognitive decline, sarcopenia, osteoporosis and sexual dysfunction. Although no such single treatment has thus far been established in humans, some clinicians and patients have set their hopes on testosterone replacement therapy (TRT) as a potential "fountain of youth" for aging men. While TRT has proven effective in ameliorating distinct symptoms of late-onset hypogonadism (LOH), its safety remains to be demonstrated. Besides humans, multiple other species exhibit age-related reductions in circulating testosterone levels, raising the question whether such changes are an inherent, pathological feature of growing organismal age or rather reflect an adaptive response. In this manuscript, we apply key principles of evolutionary medicine to testosterone biology and LOH to provide a novel perspective on these two fields. Additionally, we discuss insightful data derived from the animal kingdom to illustrate the plasticity of individual testosterone trajectories across the lifespan, outline cost-benefit-considerations of TRT in LOH and highlight potential caveats of such therapies.

Details

Original languageEnglish
Article number101301
Pages (from-to)101301
JournalAgeing Research Reviews
Volume67
Publication statusPublished - May 2021
Peer-reviewedYes
Externally publishedYes

External IDs

PubMedCentral PMC8043243
Scopus 85101358798
ORCID /0000-0002-8691-8423/work/142236042

Keywords

Sustainable Development Goals

Keywords

  • Adolescent, Aging, Hormone Replacement Therapy/adverse effects, Humans, Hypogonadism/drug therapy, Male, Osteoporosis, Testosterone