What is the evaluation and management of hypogonadism in elderly men?
Submitted by Craig Comiter, MD Response by Carol Howe, MD, MLS The primary difficulty of diagnosing hypogonadism in elderly men is the fact that many of the symptoms progress so gradually as to be almost imperceptible and also correspond with many of the symptoms attributed to aging in general. “The effect of T [testosterone] on the central nervous system extends beyond sexual behavior. T has been shown to alter mood, memory, ability to concentrate, and the overall sense of vigor and well being that may interact with a host of other psychologic changes associated with aging” (Mooradian & Korenman, 2006, abstract). “Symptoms and findings of testosterone deficiency are similar to those associated with aging. They include loss of energy, depressed mood, decreased libido, erectile dysfunction, decreased muscle mass and strength, increased fat mass, frailty, osteopenia, and osteoporosis” (Hijazi & Cunningham, 2005, abstract). “Such age-associated T deficiency, which has been termed ‘andropa
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