Recent Update on Late-onset Hypogonadism in Males

Kim, Je Jong; Moon, Du Geon

Abstract

Androgen deficiency in aging male has become a topic of increasing interest and debate throughout the world. The past decade has brought evidence that androgen treatment of hypogonadal men has benefits for multiple target organs. It is recognized that significant alterations in many endocrine systems occur in association with aging, but the significance of these changes is not well understood. In addition to its role in specific organ systems, testosterone has been found to play a role in the pathogenesis of metabolic syndrome and endothelial dysfunction. Based on data from the last 20 years, the syndrome previously called PADAM(partial androgen deficiency in aging male) is now referred to as LOH(late-onset hypogonadism), as recommended by the ISA(International Society of Andrology) at the 4th ISSAM Congress in 2004. LOH is a clinical and biochemical syndrome associated with advancing age and characterized by a set of typical symptoms accompanied by a deficiency in serum testosterone. Diagnostic tools for LOH, long-term data on the effects of testosterone replacement in aging men, and specific risk data for the prostate and cardiovascular systems are still limited. However, we have seen the recent development of a more effective and safe formulation of testosterone, e.g., Testogel 1% and a long-acting testosterone undecanoate injectable. Until better methods for caring LOH are refined, the urologists should be alert and stay current with the updates from the academic societies.