Reviews in Clinical Gerontology

Clinical geriatrics

Testosterone: clinical relevance in ageing men

Risto Huupponena1 c1, Ilpo Huhtaniemia2 and Aapo Lehtonena3

a1 Department of Pharmacology, Drug Development and Therapeutics, University of Turku and Unit of Clinical Pharmacology, Turku University Hospital, Finland

a2 Department of Reproductive Biology, Imperial College of London, UK and Department of Physiology, University of Turku, Finland

a3 Department of Geriatrics, University of Turku, and Turku City Hospital, Finland

Summary

Testosterone production declines with age in men. The decline is associated with several risk factors and diseases, including obesity and cardiovascular and metabolic diseases, diminished muscular, cognitive and sexual function and changes in body composition. Androgen treatment in elderly men has mostly been addressed in small short-term studies, and larger long-term investigations with sufficient statistical power are still needed for a proper evaluation of the benefit-risk-ratio of testosterone treatment. Current data do not support testosterone supplementation in healthy, asymptomatic older men with normal or low-normal testosterone levels. Treatment may be beneficial in older men with clear hypoandrogenic symptoms, especially reduced libido, erectile dysfunction and decreased muscle strength, if testosterone concentration is consistently low, and the patient selection, counselling and follow-up are adequate.

(Online publication December 24 2009)

Correspondence:

c1 Address for correspondence: Risto Huupponen, Department of Pharmacology, Drug Development and Therapeutics, University of Turku, Itäinen Pitkäkatu 4B, FIN-200014 Turun yliopisto, Finland. E-mail: risto.huupponen@utu.fi