Ageing male and testosterone: Current status and treatment guidelines

Abstract

Because the decline in androgens is generally gradual and not a complete deficiency, clinical significance of this decline is still unclear, and there is controversy as to whether a specific syndrome of androgen deficiency or 'andropause' exists. The term andropause or androgen deficiency in aging males (ADAM) underwent revisions to, partial androgen deficiency in aging male (PADAM), late onset hypogonadism (LOH) and now symptomatic late onset hypogonadism (SLOH), signifying, the evolving nature of this phenomenon. Since this happens at a time of life, when many men have associated comorbities, it's difficult to assess the exact impact of androgen decline, due to which, the issues surrounding androgen replacement therapy in men with symptomatic late-onset hypogonadism have been marred in controversy. Although with age, a decline in testosterone levels will occur in virtually all men, there is no way of predicting, who, will experience andropausal symptoms of sufficient severity and also long-term safety data on testosterone administration in this setting, is lacking.<b> </b> This article will focus on the controversies and practices of androgen replacement.