Author Topic: EMAS position statement: Testosterone replacement therapy in the aging male‏.  (Read 1053 times)


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Late-onset hypogonadism (LOH) represents a common clinical entity in aging males, characterized by the presence of symptoms (most usually of a sexual nature, such as decreased libido, decreased spontaneous erections and erectile dysfunction) and signs, in combination with low serum testosterone concentrations. Whether testosterone replacement therapy (TRT) should be offered to those individuals is still under extensive debate.
The aim of this position statement is to provide and critically appraise evidence on TRT in the aging male, focusing on pathophysiology and characteristics of LOH, indications for TRT, available therapeutic agents, monitoring and treatment-associated risks.
Literature review and consensus of expert opinion.
Diagnosis and treatment of LOH is justified, if a combination of symptoms of testosterone deficiency and low testosterone is present. Patients receiving TRT could profit with regard to obesity, metabolic syndrome, type 2 diabetes mellitus, sexual function and osteoporosis and should undergo scheduled testing for adverse events regularly. Potential adverse effects of TRT on cardiovascular disease, prostate cancer and sleep apnea are as yet unclear and remain to be investigated in large-scale prospective studies. Management of aging men with LOH should include individual evaluation of co-morbidities and careful risk versus benefit assessment.

C. Dimopoulou, et al., EMAS position statement: Testosterone replacement therapy in the aging male , Maturitas (2015),


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Thanks for this aq42.

I generally agree that studies like this need to be conducted more and more often. The symptoms of low testosterone are similar to those of many other conditions in all age populations, but to ageing males in-particular.

I'm sure that the greatest majority of ageing males get some form of low testosterone in their lives, but since it's an expected parted of ageing, it is important to understand if treating them with exogenous testosterone is the answer. My view is that if it is affecting their QoL detrimentally and severely then a trial at least is warranted, providing they don't have any of the yet unproven contraindications, like sleep apnea or locally treated prostate cancer, including prostatectomy.

Time will tell and I welcome these large-scale studies of data meta-analysis and other randomised trials.