Servicio de Urología, Hospital Clínic de Barcelona, Barcelona, España; Vigora, Barcelona, España.
Servicio de Urología, Hospital Clínic de Barcelona, Barcelona, España.
Actas Urol Esp (Engl Ed). 2020 Jun;44(5):294-300. doi: 10.1016/j.acuro.2019.10.009. Epub 2020 May 15.
The testosterone deficiency syndrome (TDS) is a very common clinical and biochemical condition that affects approximately 2-5% men over the age of 40. From a clinical point of view, it is usually associated with decreased sexual desire and activity, erectile dysfunction, low energy and mood swings, along with T<8-12 nmol/l levels. Questionnaires are not useful in screening but may be useful for diagnosis and follow-up. Its diagnosis requires the presentation of multiple hypogonadism symptoms together with two morning T tests below the acceptable limits. LH and SHBG levels can be useful to determine the cause and the free T level, respectively. Contraindications for treatment are active prostate cancer, stage IV heart failure, breast cancer, desired fertility and hematocrit values over 54%. Treatment is based on the cause of TDS, if any, along with testosterone supplementation. The objective is to achieve normal testosterone levels. Follow-up includes clinical history, analysis (PSA, T+SHBG, hematocrit, glucose and lipid profile) and rectal examination, 3, 6 and 12 months after beginning treatment.
男性睾酮缺乏综合征（TDS）是一种非常常见的临床和生化病症，影响大约 2-5%的 40 岁以上男性。从临床角度来看，它通常与性欲和活动减退、勃起功能障碍、能量低下和情绪波动有关，同时伴有 T<8-12 nmol/l 水平。问卷在筛查中用处不大，但可能对诊断和随访有用。其诊断需要出现多种性腺功能减退症状，并伴有两次早晨 T 测试低于可接受范围。LH 和 SHBG 水平可用于确定病因和游离 T 水平。治疗的禁忌症包括活动性前列腺癌、IV 期心力衰竭、乳腺癌、期望生育和血细胞比容值超过 54%。治疗基于 TDS 的原因，如果有任何原因，同时进行睾酮补充治疗。目标是达到正常的睾酮水平。随访包括临床病史、分析（PSA、T+SHBG、血细胞比容、血糖和血脂谱）和直肠检查，在开始治疗后 3、6 和 12 个月进行。
