Despite guidelines agreeing that male hypogonadism should be diagnosed and managed in aged men as in adulthood, trials assessing the efficacy of T therapy conducted for male rejuvenating are lacking, and T prescription for this purpose is not recommended.
Key Findings
Background
Late-Onset Hypogonadism (LOH) is defined as a clinical and biochemical syndrome associated with advancing age characterized by specific symptoms and testosterone deficiency.
LOH is characterized by specific symptoms and less specific manifestations due to deficiency of serum testosterone levels
The condition is associated with advancing age
The review synthesized evidence from MEDLINE/PubMed and institutional websites for original papers, guidelines, and position statements published in the last ten years
Results
All reviewed guidelines agreed that male hypogonadism should be diagnosed and managed in aged men in the same manner as in adulthood.
Despite some heterogeneities regarding diagnostic definition, therapeutic target, and testosterone prescription, consensus existed across guidelines
Both observational and randomized controlled studies on testosterone replacement therapy in older men were reviewed
Guidelines from multiple institutional sources were included in the review
Conclusions
Clinical trials assessing the efficacy of testosterone therapy for male rejuvenation are lacking, and testosterone prescription for this purpose is not recommended.
The review found an absence of trials specifically assessing testosterone therapy conducted for 'male rejuvenating' purposes
The paper frames the clinical question as whether testosterone is the 'fountain of youth' for aging men, and concludes the evidence does not support this use
Testosterone prescription for rejuvenation purposes is explicitly stated as not recommended
Results
There are heterogeneities among guidelines regarding the diagnostic definition, therapeutic target, and testosterone prescription for LOH.
Despite overall agreement on managing hypogonadism similarly across age groups, heterogeneities exist in diagnostic criteria used across guidelines
Differences were noted in therapeutic targets for testosterone replacement
Variability in testosterone prescription approaches was identified across different guidelines and position statements
Giagulli V, Lisco G, Mariano F, De Tullio A, Triggiani V. (2023). Is Testosterone the "Fountain of Youth" for Aging Men?. Endocrine, metabolic & immune disorders drug targets. https://doi.org/10.2174/1871530322666220516160435