睾酮、情绪、行为和生活质量。

Testosterone, mood, behaviour and quality of life.

机构信息

Center for Reproductive Medicine and Andrology/Clinical Andrology, University Hospital, Münster, Germany.

出版信息

Andrology. 2020 Nov;8(6):1598-1605. doi: 10.1111/andr.12867. Epub 2020 Jul 30.

Abstract

Testosterone plays a pivotal role in maintaining balance within the multi-dimensional psychological network of mood, behaviour, self-perception and perceived quality of life in men of any age. Apart from classical forms of hypogonadism, low testosterone concentrations can also be seen in older men, described as an age- and comorbidity-driven functional hypogonadism and might relate to depressive symptoms exhibiting a wide array of clinical pictures ranging from dysthymia and fatigue over inertia, listlessness to hopelessness and suicidal thoughts. Also, various traits of anxiety, from unfocussed fear to phobic anxiousness and open panic syndromes, are influenced by testosterone. Correspondingly, anxiolysis is likely to be modulated by testosterone via stress resilience, threat vigilance and reward processing. The steroid modulates pro-active and re-active dimensions of aggression, which has to be seen within the context of gaining or maintaining status. This may also include other strategies impacting the social position: heroic or parochial altruism and non-aggressive paths of assertiveness, such as posture and social vigilance. Independent rather than relationship-associated self-construal and self-esteem influence risk-taking traits under the modulation of testosterone. In addition, the genetic setting of the androgen receptor modulates the role of testosterone in aspects regarding mood and personality. Dimensions of sexuality are rather important in this context, but are not target of this article and covered in another part of this special edition. Overall, the quality of life in older hypogonadal men can be positively influenced by testosterone substitution, as has been demonstrated in large placebo-controlled trials.

摘要

睾酮在维持男性多维心理网络中的情绪、行为、自我认知和生活质量感知的平衡方面起着关键作用,无论年龄大小。除了经典形式的性腺功能减退症外,老年男性也可能出现低睾酮浓度,这种情况被描述为年龄和合并症驱动的功能性性腺功能减退症,可能与表现出从心境恶劣和疲劳、倦怠到绝望和自杀念头等广泛临床表现的抑郁症状有关。此外,各种焦虑特征,从无焦点的恐惧到恐惧症焦虑和开放性恐慌综合征,也受到睾酮的影响。相应地,通过应激弹性、威胁警觉和奖励处理,焦虑症可能会被睾酮调节。类固醇调节主动性和反应性攻击维度,这必须在获得或维持地位的背景下看待。这可能还包括其他影响社会地位的策略:英勇或狭隘的利他主义和非攻击性的自信途径,如姿势和社会警觉。独立而非与关系相关的自我概念和自尊在睾酮的调节下影响冒险特质。此外,雄激素受体的遗传背景调节了睾酮在情绪和个性方面的作用。在这方面,性维度非常重要,但不是本文的目标,将在特刊的另一部分中讨论。总的来说,在大型安慰剂对照试验中已经证明,睾酮替代疗法可以积极影响老年性腺功能减退症男性的生活质量。

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