Üçer Oktay, Gümüş Bilal
Department of Urology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.
Turk J Urol. 2014 Sep;40(3):170-9. doi: 10.5152/tud.2013.97752. Epub 2014 Mar 24.
Late-onset hypogonadism (LOH) in aging men is a clinical and biochemical syndrome caused by an age-related decline in testosterone. Despite published in guidelines and recommendations, uncertainty surrounds the profile of clinical symptoms as well as the biochemical threshold of diagnosis. The only evidence-based treatment of late-onset hypogonadism is testosterone replacement therapy. The actual available evidence of the long-term risks and outcomes of testosterone-replacement therapy remains very limited, and carefully designed placebo-controlled trials of testosterone administration to assess the risks and benefits of such a therapy are required. Until such evidence is available, testosterone treatment should be restricted to elderly men with very low testosterone levels in the presence of clinical symptoms, and the advantages and disadvantages need to be accurately assessed. Careful monitoring of potential side effects is necessary. The purpose of this review is to discuss what is known and what remains unclear with respect to the benefits and risks of testosterone replacement treatment.
老年男性迟发性性腺功能减退（LOH）是一种由睾酮随年龄增长而下降引起的临床和生化综合征。尽管已发布在指南和建议中，但临床症状特征以及诊断的生化阈值仍存在不确定性。迟发性性腺功能减退唯一基于证据的治疗方法是睾酮替代疗法。关于睾酮替代疗法长期风险和结果的实际可用证据仍然非常有限，需要精心设计的睾酮给药安慰剂对照试验来评估这种疗法的风险和益处。在获得此类证据之前，睾酮治疗应仅限于有临床症状且睾酮水平极低的老年男性，并且需要准确评估其利弊。仔细监测潜在副作用是必要的。本综述的目的是讨论关于睾酮替代治疗的益处和风险已知的和仍不清楚的方面。
