Ahmed Talha, Alattar May, Pantalone Kevin, Haque Reyaz
Internal Medicine, University of Maryland Medical Center, Baltimore, USA.
Endocrinology, University of Maryland, Baltimore, USA.
Cureus. 2020 Mar 19;12(3):e7324. doi: 10.7759/cureus.7324.
Testosterone is an anabolic hormone that is responsible for the development of male sex organs. It also increases muscle mass and fortifies bone density. In addition to being responsible for primary sexual characteristics at birth and puberty (development and changes of sexual organs such as uterus, vagina, penis, and testes), testosterone is also involved in maintaining secondary sexual characteristics. Patients with low testosterone who are symptomatic should be treated with testosterone replacement therapy (TRT) once the diagnosis has been confirmed. The goal of treatment is to improve the symptoms including the physical, sexual, and cognitive health with the aim being to keep the testosterone in the mid-normal limit of the reference range. Male hypogonadism has been increasingly diagnosed and treated in elderly males since the last decade. A proportionate increase in the prescription of testosterone has been seen as well. The relationship of testosterone levels with cardiovascular (CV) outcomes is challenging and has shown conflicting results. Moreover, in patients with established CV disease, those with high CV risk factors including diabetes, or those with significant risk factors for atherosclerotic CV disease (ASCVD), the benefits of TRT should be weighed against the risks of replacement. Risks and benefits of TRT should be discussed with every patient prior to starting or restarting the procedure.
睾酮是一种合成代谢激素，负责男性性器官的发育。它还能增加肌肉量并强化骨密度。除了在出生时和青春期负责第一性征（如子宫、阴道、阴茎和睾丸等性器官的发育和变化）外，睾酮还参与维持第二性征。确诊后，有症状的低睾酮患者应接受睾酮替代疗法（TRT）治疗。治疗目标是改善包括身体、性和认知健康在内的症状，目的是将睾酮水平维持在参考范围的正常上限。自上一个十年以来，老年男性中男性性腺功能减退的诊断和治疗越来越多。睾酮处方量也相应增加。睾酮水平与心血管（CV）结局的关系具有挑战性，结果相互矛盾。此外，在已确诊患有心血管疾病的患者、有包括糖尿病在内的高心血管风险因素的患者或有动脉粥样硬化性心血管疾病（ASCVD）重大风险因素的患者中，应权衡TRT的益处与替代治疗的风险。在开始或重新开始该治疗之前，应与每位患者讨论TRT的风险和益处。
