The Role of Testosterone in the Elderly: What Do We Know?

Author:

Barone BiagioORCID,Napolitano LuigiORCID,Abate Marco,Cirillo Luigi,Reccia Pasquale,Passaro Francesco,Turco Carmine,Morra SimoneORCID,Mastrangelo Francesco,Scarpato Antonio,Amicuzi Ugo,Morgera Vincenzo,Romano Lorenzo,Calace Francesco Paolo,Pandolfo Savio DomenicoORCID,De Luca Luigi,Aveta AchilleORCID,Sicignano EnricoORCID,Trivellato Massimiliano,Spena GianlucaORCID,D’Alterio Carlo,Fusco Giovanni Maria,Vitale RaffaeleORCID,Arcaniolo DavideORCID,Crocetto FeliceORCID

Abstract

Testosterone is the most important hormone in male health. Aging is characterized by testosterone deficiency due to decreasing testosterone levels associated with low testicular production, genetic factors, adiposity, and illness. Low testosterone levels in men are associated with sexual dysfunction (low sexual desire, erectile dysfunction), reduced skeletal muscle mass and strength, decreased bone mineral density, increased cardiovascular risk and alterations of the glycometabolic profile. Testosterone replacement therapy (TRT) shows several therapeutic effects while maintaining a good safety profile in hypogonadal men. TRT restores normal levels of serum testosterone in men, increasing libido and energy level and producing beneficial effects on bone density, strength and muscle as well as yielding cardioprotective effects. Nevertheless, TRT could be contraindicated in men with untreated prostate cancer, although poor findings are reported in the literature. In addition, different potential side effects, such as polycythemia, cardiac events and obstructive sleep apnea, should be monitored. The aim of our review is to provide an updated background regarding the pros and cons of TRT, evaluating its role and its clinical applicability in different domains.

Publisher

MDPI AG

Subject

Inorganic Chemistry,Organic Chemistry,Physical and Theoretical Chemistry,Computer Science Applications,Spectroscopy,Molecular Biology,General Medicine,Catalysis

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