Late-onset hypogonadism: Clinical evidence, biological aspects and evolutionary considerations
Research output: Contribution to journal › Review article › Contributed › peer-review
Contributors
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 language | English |
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Article number | 101301 |
Pages (from-to) | 101301 |
Journal | Ageing Research Reviews |
Volume | 67 |
Publication status | Published - May 2021 |
Peer-reviewed | Yes |
Externally published | Yes |
External IDs
PubMedCentral | PMC8043243 |
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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