Adult- and late-onset male hypogonadism: the clinical practice guidelines of the Italian Society of Andrology and Sexual Medicine (SIAMS) and the Italian Society of Endocrinology (SIE).
Bone mineral density
Erectile dysfunction
Hypogonadism
Late-onset hypogonadism
Metabolic syndrome
Obesity
Testosterone
Journal
Journal of endocrinological investigation
ISSN: 1720-8386
Titre abrégé: J Endocrinol Invest
Pays: Italy
ID NLM: 7806594
Informations de publication
Date de publication:
Dec 2022
Dec 2022
Historique:
received:
19
05
2022
accepted:
29
06
2022
pubmed:
27
8
2022
medline:
15
11
2022
entrez:
26
8
2022
Statut:
ppublish
Résumé
To provide the evidence-based recommendations on the role of testosterone (T) on age-related symptoms and signs remains. The Italian Society of Andrology and Sexual Medicine (SIAMS) and the and the Italian Society of Endocrinology (SIE) commissioned an expert task force to provide an updated guideline on adult-onset male hypogonadism. Derived recommendations were based on Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. Clinical diagnosis of adult-onset hypogonadism should be based on a combination of clinical and biochemical parameters. Testosterone replacement therapy (TRT) should be offered to all symptomatic subjects with hypogonadism after the exclusion of possible contraindications. T gels and the long-acting injectable T are currently available preparations showing the best efficacy/safety profile. TRT can improve all aspects of sexual function, although its effect is limited in more complicated patients. Body composition (reducing fat mass and increasing lean mass) is improved after TRT, either in subjects with or without metabolic syndrome or type 2 diabetes. Conversely, the role of TRT in improving glycometabolic control is more conflicting. TRT can result in increasing bone mineral density, particularly at lumbar site, but no information on fracture risk is available. Limited data support the use of TRT for improving other outcomes, including mood frailty and mobility. TRT can improve sexual function and body composition particularly in less complicated adult and in aging subjects with hypogonadism. When hypogonadism is adequately diagnosed, T appropriately prescribed and subjects correctly followed up, no short-term increased risk of adverse events is observed. Longer and larger studies are advisable to better clarify TRT long-term efficacy/safety profile.
Identifiants
pubmed: 36018454
doi: 10.1007/s40618-022-01859-7
pii: 10.1007/s40618-022-01859-7
pmc: PMC9415259
doi:
Substances chimiques
Testosterone
3XMK78S47O
Types de publication
Journal Article
Practice Guideline
Langues
eng
Sous-ensembles de citation
IM
Pagination
2385-2403Informations de copyright
© 2022. The Author(s), under exclusive licence to Italian Society of Endocrinology (SIE).
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