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Review
. 2017 Jul 4;8(5):545-570.
doi: 10.1080/21505594.2016.1259053. Epub 2016 Nov 10.

Aging and sex hormones in males

Maria Chiara Decaroli  1 , Vincenzo Rochira  1   2
Affiliations
Review

Aging and sex hormones in males

Maria Chiara Decaroli et al. Virulence. .

Abstract

Several large cohort studies have disclosed the trajectories of sex steroids changes overtime in men and their clinical significance. In men the slow, physiological decline of serum testosterone (T) with advancing age overlaps with the clinical condition of overt, pathological hypogonadism. In addition, the increasing number of comorbidities, together with the high prevalence of chronic diseases, all further contribute to the decrease of serum T concentrations in the aging male. For all these reasons both the diagnosis of late-onset hypogonadism (LOH) in men and the decision about starting or not T replacement treatment remain challenging. At present, the biochemical finding of T deficiency alone is not sufficient for diagnosing hypogonadism in older men. Coupling hypogonadal symptoms with documented low serum T represents the best strategy to refine the diagnosis of hypogonadism in older men and to avoid unnecessary treatments.

Keywords: bone mineral density; estradiol; late-onset hypogonadism (LOH); menopause; replacement treatment; sex steroids; testosterone.

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Figures

Figure 1.
Figure 1.
Serum levels of both testosterone (T) (solid lines) and estradiol (E2)* (broken lines) across the lifespan in men (blue lines) and women (pink lines). Data used for plotting age-related sex steroids changes in both sexes have been derived from Kaufman & Vermeulen 20055, Zmuda et al. 19976 (for men), and from Al-Safi et al. 20002 and Veldhuis 2013 (for women). serum E2 levels of premenopausal women are represented as the mean of E2 measured during the different phases of the menstrual cycle; T: testosterone; E2: estradiol.
Figure 2.
Figure 2.
Classification of hypogonadism according to its pathogenesis.
Figure 3.
Figure 3.
Signs and symptoms of late-onset hypogonadism according to their specificity.
See this image and copyright information in PMC

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