Modern algorithms for diagnosis and treatment of age-related androgen deficiency

Modern algorithms for diagnosis and treatment of age-related androgen deficiency

Yu.A. Redkin

Moscow Regional Research and Clinical Institute named after M.F. Vladimirskiy, Moscow, Russia

In older men serum testosterone levels steadily decrease with age. There are large individual variations in testosterone concentrations. The most frequent clinical manifestations of age-related androgen deficiency are reduced libido, erectile dysfunction, reduced muscle mass, low bone mineral density, faintness, metabolic syndrome and depression. Differential diagnosis of age-related androgen deficiency with diseases accompanied by similar symptoms should be made, and general health should be assessed to exclude systemic disease, eating disorders, excessive physical activity, sleep disturbances and undesirable reactions when using medications that affect testosterone production or metabolism. Replacement therapy with testosterone may relieve symptoms associated with androgen deficiency. Potential risks and benefits of such treatment should be discussed in detail with the patient. However, such therapy is not recommended for men aged 65 and over, even with low testosterone concentrations in the blood. Treatment with testosterone helps to improve libido and sexual function, increase mood, muscle mass and strength, normalize lipid and glycemic profiles, mineral bone density.

Keywords: androgen deficiency, hormone replacement therapy, testosterone medications.
For citation: Redkin Yu.A. Modern algorithms for diagnosis and treatment of age-related androgen deficiency. RMJ. Medical Review. 2019;1(I):31–35.