Gooren L
Department of Endocrinology, VU University Medical Center, Amsterdam, The Netherlands.
Front Horm Res. 2009;37:62-73. doi: 10.1159/000176045.
With aging, a significant percentage of men over the age of 60 years have serum testosterone levels below the lower limits of young adult men. Testosterone is not only pivotal for male reproductive/sexual functioning but plays also a significant role in the maintenance of bone and muscle mass and is a determinant of glucose homeostasis and lipid metabolism. The metabolic syndrome, erectile dysfunction and patterns of testosterone in aging men are intertwined. Testosterone is a factor in libido but also exerts essential effects on the anatomical and physiological substrate of penile erection. With these recent insights, the health problems of elderly men must be placed in a context that allows an integral approach. Treatment of testosterone deficiency is to become part of this approach. Recently, professional organizations have published guidelines in an attempt to define the condition and provide treatment. Despite this, much confusion still exists regarding the appropriate approach to diagnosing late-onset hypogonadism. Side effects concern mainly the prostate and erythropoeisis, but the currently available literature indicates that there is no increased risk of developing prostate cancer in men receiving testosterone treatment. Administration of testosterone to elderly men with testosterone deficiency is an acceptably safe practice.
随着年龄增长，60岁以上的男性中有很大比例的人的血清睾酮水平低于年轻成年男性的下限。睾酮不仅对男性生殖/性功能至关重要，而且在维持骨骼和肌肉质量方面也起着重要作用，并且是葡萄糖稳态和脂质代谢的决定因素。老年男性的代谢综合征、勃起功能障碍和睾酮模式相互交织。睾酮是性欲的一个因素，但对阴茎勃起的解剖学和生理学基础也有重要影响。基于这些最新见解，老年男性的健康问题必须放在一个能采取综合方法的背景下来看待。睾酮缺乏的治疗将成为这种方法的一部分。最近，专业组织已发布指南，试图界定这种情况并提供治疗方法。尽管如此，对于诊断迟发性性腺功能减退的适当方法仍存在很多困惑。副作用主要涉及前列腺和红细胞生成，但目前可得的文献表明，接受睾酮治疗的男性患前列腺癌的风险并未增加。给睾酮缺乏的老年男性使用睾酮是一种可接受的安全做法。
