Department of Urology, Tulane Health Sciences Center, New Orleans, Louisiana, USA.
Ther Adv Urol. 2010 Jun;2(3):99-104. doi: 10.1177/1756287210369805.
Male hypogonadism, or testosterone deficiency syndrome (TDS), results from a failure of the testes to produce adequate androgen. Patients have low circulating testosterone in combination with clinical symptoms such as fatigue, erectile dysfunction, and body composition changes. The cause may be primary (genetic anomaly, Klinefelter's syndrome) or secondary (defect in hypothalamus or pituitary), but often presents with the same symptomatology. In the older patient, androgen deficiency of the aging male (ADAM) is an important cause of secondary hypogonadism because testosterone levels decline progressively after age 40. Hypogonadal patients have alterations not only in sexual function and body composition, but also in cognition and metabolism. Regardless of etiology, hypogonadal patients who are both symptomatic and who have clinically significant alterations in laboratory values are candidates for treatment. The goal of hormone replacement therapy in these men is to restore hormone levels to the normal range and to alleviate symptoms suggestive of hormone deficiency. This can be accomplished in a variety of ways, although most commonly testosterone replacement therapy (TRT) is employed.
男性性腺功能减退症，或称为睾丸激素缺乏症（TDS），是由于睾丸无法产生足够的雄激素而导致的。患者的循环睾丸激素水平降低，同时伴有疲劳、勃起功能障碍和身体成分改变等临床症状。病因可能是原发性的（遗传异常、克莱恩费尔特氏综合征）或继发性的（下丘脑或垂体缺陷），但通常表现出相同的症状。在老年患者中，男性迟发性性腺功能减退症（ADAM）是继发性性腺功能减退症的一个重要原因，因为睾丸激素水平在 40 岁后会逐渐下降。性腺功能减退症患者不仅性功能和身体成分会发生改变，认知和代谢也会发生改变。无论病因如何，有症状且实验室检查值有临床显著改变的性腺功能减退症患者都适合进行治疗。这些男性的激素替代治疗的目标是将激素水平恢复到正常范围，并缓解激素缺乏的症状。这可以通过多种方式实现，尽管最常用的方法是睾丸激素替代治疗（TRT）。
