Male climacteric syndrome: Late Onset Hypogonadism (LOH) in males

Yoo, Soon Jib

Abstract

Male climacteric syndrome is a clinical and biochemical syndrome characterized by the decline in serum concentration of biologically active forms of testosterone with aging in men which may result in detrimental effect on the quality of life(QOL) and adversely affect the function of multiple organ systems. Androgen replacement therapy may have favorable effect in QOL, body composition, cardiovascular disease, sexual dysfunction and osteoporosis. Controversy in defining the clinical syndrome and in long-term effect of androgen replacement therapy continues. An international consensus document was recently published and provides guidance on the diagnosis, treatment and monitoring of late-onset hypogonadism (LOH) in males. The diagnosis of LOH requires biochemical and clinical components. Any clinical intervention testosterone treatment should be judged on a balance of risk versus benefit. There have been potential concerns regarding the effects of testosterone on prostate disease and polycythemia. The available treatment methods have increased in recent years with the availability of a number of testosterone preparations which can reliably produce physiological serum concentrations. Periodic physician's evaluations is required to assess the clinical response and to avoid potential adverse events and must be tailored individually.