Vol 63, Supp. II (2012)
Review paper
Published online: 2012-12-31
Late onset hypogonadism in men
Abstract
Late onset hypogonadism (LOH) is clinical and biochemical syndrome associated with advancing age and characterized by symptoms and
a deficiency in serum testosterone levels and/or action. Its pathogenesis and incidence has not been known up till now. Controversies have
grown upon a lack of clear diagnostic criteria, especially non-specific symptoms and not established lower reference limit of testosterone
serum level. Because of these diagnosis of LOH was variously determined. Nevertheless, substitution with testosterone in older men was
recommended. European Male Aging Study (EMAS), the biggest prospective clinical study, indicated that physical and psychical LOH
symptoms, considered yet as certain, do not show relation with fluctuations of testosterone levels dependent on the age. Moreover, it
appears that decrease of testosterone with advancing age is lower than was suspected. Between 40 and 79 year of age it comes to –0.4%/
/year for total testosterone and –1.3%/year for free testosterone. It was found also that these changes depend mainly on modified risk factors
for health but not specifically on aging. A contemporary definition of LOH is that it is occurrence of three sexual symptoms and decline
of serum testosterone level below 11 nmol/L. These symptoms are: absence of morning erections, erectile dysfunction and disappearance
of sexual fantasies. (Endokrynol Pol 2012; 63 (education supplement II) 15–19)
Keywords: mentestosteroneaging