Testosterone is an essential factor for maintaining physical and emotional well-being in men regardless of age, and testosterone replacement therapy following international guidelines can produce clear improvement in complaints caused by hypogonadism, though functional hypogonadism always requires treatment of underlying comorbidity prior to starting testosterone administration.
Key Findings
Background
Male hypogonadism is classified into three types based on etiology: primary, secondary, and functional.
Primary hypogonadism results from testicular injury.
Secondary hypogonadism results from diseases of the hypothalamus or pituitary gland.
Functional hypogonadism results from comorbidities such as obesity, type 2 diabetes mellitus, and inflammatory diseases.
Background
Testosterone deficiency causes multiple physical, metabolic, and psychosocial problems in men.
Testosterone deficiency causes problems of a sexual nature.
It promotes metabolic disequilibrium.
It impairs physical abilities, including reduction in muscle mass and increase in fat mass.
In the condition of hypogonadism, depression, osteoporosis, and/or anemia often develop.
Background
Testosterone replacement therapy has specific contraindications that preclude its initiation.
Testosterone replacement therapy should not be initiated in cases of a desire to have children.
It is contraindicated with unclear processes of the prostate glands or mammary glands.
It is also contraindicated in cases of an elevated hematocrit value.
Conclusions
Functional hypogonadism, mostly diagnosed in older men, requires treatment of the underlying comorbidity before testosterone administration is started.
Functional hypogonadism is mostly but not exclusively diagnosed in older men.
Treatment of the underlying comorbidity is always required prior to starting testosterone administration in functional hypogonadism.
Comorbidities associated with functional hypogonadism include obesity, type 2 diabetes mellitus, and inflammatory diseases.
Conclusions
When diagnosis, treatment, and monitoring of testosterone replacement therapy follow international guidelines, a clear improvement in hypogonadism-related complaints can be expected.
The paper states that 'a clear improvement in the abovenamed complaints can be expected' when international guidelines are followed.
Complaints addressed include sexual problems, metabolic disequilibrium, reduced muscle mass, increased fat mass, depression, osteoporosis, and anemia.
Both diagnosis and treatment monitoring must adhere to international guidelines for optimal outcomes.