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Review

Androgen deficiency in older men: Indications, advantages, and pitfalls of testosterone replacement therapy

John J. McGill, MD, Daniel A. Shoskes, MD and Edmund S. Sabanegh, MD
Cleveland Clinic Journal of Medicine November 2012, 79 (11) 797-806; DOI: https://doi.org/10.3949/ccjm.79a.12010
John J. McGill
Urology Institute, University Hospitals Case Medical Center, Cleveland, OH
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  • For correspondence: mcgill@uhhospitals.org
Daniel A. Shoskes
Glickman Urological and Kidney Institute, Cleveland Clinic
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Edmund S. Sabanegh Jr.
Chairman, Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic
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ABSTRACT

The decline in testosterone with age has been associated with specific physical changes that affect quality of life and life expectancy, although a cause-and-effect relationship is yet to be established. While female menopause is rapid and well described, “male menopause” or androgen decline in older men is gradual and marked by nonspecific symptoms. This makes diagnosis of true testosterone deficiency and prediction of response to testosterone replacement therapy (TRT) challenging. This article reviews androgen decline in men, focusing on those over age 40, and covers symptoms, indications, contraindications, diagnosis, treatments, and the risks and benefits of treatment.

Footnotes

  • ↵* Dr. Shoskes has disclosed that he has served as a consultant for study design for Astellas.

  • Copyright © 2012 The Cleveland Clinic Foundation. All Rights Reserved.

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Cleveland Clinic Journal of Medicine: 79 (11)
Cleveland Clinic Journal of Medicine
Vol. 79, Issue 11
1 Nov 2012
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Androgen deficiency in older men: Indications, advantages, and pitfalls of testosterone replacement therapy
John J. McGill, Daniel A. Shoskes, Edmund S. Sabanegh
Cleveland Clinic Journal of Medicine Nov 2012, 79 (11) 797-806; DOI: 10.3949/ccjm.79a.12010

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Androgen deficiency in older men: Indications, advantages, and pitfalls of testosterone replacement therapy
John J. McGill, Daniel A. Shoskes, Edmund S. Sabanegh
Cleveland Clinic Journal of Medicine Nov 2012, 79 (11) 797-806; DOI: 10.3949/ccjm.79a.12010
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