Lejeune H, Huyghe É, Droupy S
Inserm U 846, service de médecine de la reproduction, université Claude-Bernard-Lyon-1, hôpital Femme-Mère-Enfant, CHU de Lyon, 59, boulevard Pinel, 69500 Bron, France.
Prog Urol. 2013 Jul;23(9):621-8. doi: 10.1016/j.purol.2013.01.019. Epub 2013 Apr 4.
Relations between sexual desire and testosterone are more complex than previously thought particularly in ageing males.
A Medline search of the existing literature utilizing terms testosterone, libido, sexual desire, hypogonadism, and andropause, was performed until January 2012.
Testosterone is a physiological stimulator of sexual desire. In case of complete hypogonadism, libido is very low and testosterone treatment restores sexual desire. In epidemiological studies, the relationship between testosterone and sexual desire is statistically significant but less strict because of interactions with other factors which decrease both sexual desire and testosterone levels. It is especially the case in ageing males: in addition to a possible late-onset hypogonadism, other etiological factors (health, partnership, socioeconomical and psychological factors) and other sexual dysfunctions (such as erectile dysfunction) must be taken into account.
The decrease of sexual desire is one of the symptoms seen in late-onset hypogonadism. The effect of testosterone replacement therapy is more obvious that testosterone is low and there are no other causes of impaired sexual desire. There is no evidence that testosterone therapy increases the risk of prostate cancer, benign prostatic hyperplasia or promotes the clinical expression of subclinical prostate cancer.
性欲与睾酮之间的关系比之前认为的更为复杂，尤其是在老年男性中。
截至2012年1月，利用“睾酮”“性欲”“性欲望”“性腺功能减退”和“男性更年期”等术语对现有文献进行了医学文献数据库检索。
睾酮是性欲的生理刺激因素。在完全性腺功能减退的情况下，性欲非常低，而睾酮治疗可恢复性欲。在流行病学研究中，睾酮与性欲之间的关系具有统计学意义，但由于与其他降低性欲和睾酮水平的因素相互作用，这种关系并不那么严格。在老年男性中尤其如此：除了可能存在迟发性性腺功能减退外，还必须考虑其他病因因素（健康、伴侣关系、社会经济和心理因素）以及其他性功能障碍（如勃起功能障碍）。
性欲减退是迟发性性腺功能减退的症状之一。睾酮替代疗法的效果在睾酮水平较低且不存在其他性欲受损原因时更为明显。没有证据表明睾酮治疗会增加前列腺癌、良性前列腺增生的风险或促进亚临床前列腺癌的临床表达。
