Allan Carolyn A, McLachlan Robert I
Prince Henry's Institute of Medical Research, Department of Obstetrics and Gynaecology, Monash University, Victoria.
Aust Fam Physician. 2003 Jun;32(6):422-7.
Testosterone deficiency (hypoandrogenism) is the commonest hormonal deficiency in men but its clinical presentation may be subtle and its diagnosis overlooked unless actively considered.
This article aims to provide an overview of the presentation of hypoandrogenism and the essential diagnostic role of the endocrine laboratory. We also seek to outline current treatment options and highlight the controversial area of age related hypoandrogenism with an emphasis on results from placebo controlled studies.
The causes of hypogonadism in younger men are well documented but its presentation may be nonspecific and the diagnosis in older men may be difficult. It is likely that testosterone deficiency is widely under diagnosed. Endocrine testing provides essential supportive data for diagnosis and assists in monitoring treatment. The Endocrine Society of Australia has developed guidelines to assist practitioners in the diagnosis and management of hypoandrogenism in younger and older men. Testosterone replacement effectively restores sexual health and other androgen dependent actions on mood/cognition, muscle and bone. Testosterone treatment in symptomatic aging men with borderline hypoandrogenism is controversial and the benefits (and risks) of testosterone therapy remain uncertain.
睾酮缺乏（性腺功能减退）是男性最常见的激素缺乏症，但其临床表现可能不明显，除非主动考虑，否则其诊断可能被忽视。
本文旨在概述性腺功能减退的表现以及内分泌实验室的重要诊断作用。我们还试图概述当前的治疗选择，并强调与年龄相关的性腺功能减退这一有争议的领域，重点介绍安慰剂对照研究的结果。
年轻男性性腺功能减退的原因已有充分记录，但其表现可能不具特异性，老年男性的诊断可能困难。睾酮缺乏很可能广泛存在漏诊情况。内分泌检测为诊断提供重要的支持数据，并有助于监测治疗。澳大利亚内分泌学会已制定指南，以协助从业者诊断和管理年轻及老年男性的性腺功能减退。睾酮替代疗法可有效恢复性健康以及对情绪/认知、肌肉和骨骼的其他雄激素依赖性作用。对有症状的边缘性性腺功能减退老年男性进行睾酮治疗存在争议，睾酮治疗的益处（和风险）仍不确定。
