Zitzmann Michael
Klinische Andrologie des Centrum für Reproduktionsmedizin und Andrologie, Universitätsklinikum Münster, Domagkstr. 11, 48149, Münster, Deutschland.
Inn Med (Heidelb). 2025 Jan;66(1):114-123. doi: 10.1007/s00108-024-01824-x. Epub 2024 Dec 21.
Testosterone is a natural hormone which is an essential factor to maintain the physical and emotional well-being in men, regardless of age. Male hypogonadism is an endocrinal condition of testosterone deficiency with the potential to cause multiple physical complaints and psychosocial problems. The condition can be of primary (due to testicular injury), secondary (due to diseases of the hypothalamus or pituitary gland) or functional nature (due to comorbidities, such as inflammatory diseases, obesity, type 2 diabetes mellitus). Testosterone deficiency causes problems of a sexual nature, promotes metabolic disequilibrium and can impair physical abilities (reduction in muscle mass, increase in fat mass). In addition, in the condition of hypogonadism depression, osteoporosis and/or anemia often develop. A testosterone replacement therapy should not be initiated in cases of a desire to have children, unclear processes of the prostate glands or mammary glands or an elevated hematocrit value. The diagnosis as well as treatment and monitoring of the treatment should follow the international guidelines and then a clear improvement in the abovenamed complaints can be expected. Particularly functional hypogonadism, which is mostly but not exclusively diagnosed in older men, always requires treatment of the underlying comorbidity prior to starting testosterone administration.
睾酮是一种天然激素,是维持男性身心健康的重要因素,无论年龄大小。男性性腺功能减退是一种睾酮缺乏的内分泌疾病,有可能导致多种身体不适和心理社会问题。这种疾病可能是原发性的(由于睾丸损伤)、继发性的(由于下丘脑或垂体疾病)或功能性的(由于合并症,如炎症性疾病、肥胖症、2型糖尿病)。睾酮缺乏会导致性方面的问题,促进代谢失衡,并可能损害身体能力(肌肉量减少,脂肪量增加)。此外,在性腺功能减退的情况下,常出现抑郁症、骨质疏松症和/或贫血。在有生育愿望、前列腺或乳腺情况不明或血细胞比容值升高的情况下,不应开始睾酮替代疗法。诊断以及治疗和治疗监测应遵循国际指南,这样上述不适有望得到明显改善。特别是功能性性腺功能减退,大多但并非仅在老年男性中诊断出来,在开始给予睾酮之前,总是需要先治疗潜在的合并症。