World J Mens Health.  2020 Apr;38(2):178-190. 10.5534/wjmh.190006.

Testosterone and Dehydroepiandrosterone Treatment in Ageing Men: Are We All Set?

Affiliations
  • 1Department of Biological Psychology, TU Dresden, Dresden, Germany. andreas.walther@tu-dresden.de
  • 2Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland.
  • 3Task Force on Men's Mental Health of the World Federation of the Societies of Biological Psychiatry (WFSBP).

Abstract

Although demographic statistics show that populations around the world are rapidly ageing, this rising life expectancy is accompanied by an increase in the number of people living with age-related chronic conditions, such as frailty, cognitive decline, depression, or sexual dysfunction. In men, a progressive decline in androgens occurs with increasing age, and low androgen levels are associated with age-related chronic conditions. However, androgen administration studies are inconclusive, showing differing results according to the androgen used (testosterone [T], dehydroepiandrosterone [DHEA]), the group of men examined (younger vs. older; eugonadal vs. hypogonadal) and the conditions studied (frailty, cognitive decline, depression, sexual dysfunction). In this review, the current state for the use of T and DHEA therapy in men for the age-related conditions is examined. Due to the progressive age-related decline in androgens leading to a higher rate of older men having low androgen levels, the effects of androgen treatment in elderly males will be of particular interest in this review. Dose-response relationships, the role of potential moderators, and the androgen treatment-related risk for adverse events will be discussed. Studies have suggested that T treatment - more so than DHEA treatment - may be an effective therapy against age-related chronic conditions in men with low T levels; especially older men. Such conditions include frailty, depression, or sexual dysfunction. However, T treatment does not emerge as an effective therapy against cognitive decline. Nevertheless, more high-quality, randomised controlled trials using T treatment for age-related chronic conditions are necessary if further conclusions are to be made.

Keyword

Aging; Dehydroepiandrosterone; Testosterone; Men; Healthy aging; Morbidity

MeSH Terms

Aged
Aging
Androgens
Dehydroepiandrosterone*
Depression
Humans
Life Expectancy
Male
Testosterone*
Androgens
Dehydroepiandrosterone
Testosterone
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