PubMed · 16888853
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Rainer Hakimi. 2006-07-06. [Hormone substitution--a questionable IGeL indication].. https://pubmed.ncbi.nlm.nih.gov/16888853/
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The progressive decline in testosterone level has been demonstrated in both cross-sectional and longitudinal studies, and overall at least 25% of men over the age of 70 years meet laboratory criteria for hypogonadism (i.e., testosterone deficiency). Such age-associated HPG hypofunctioning, which has been termed 'andropause', is thought to be responsible for a variety of symptoms experienced by elderly men, including sexual dysfunction and depression. Although, it has been difficult to establish correlations between 'andropausal' symptoms and plasma testosterone levels, there is some evidence that testosterone replacement leads to improvement in muscle strength, bone mineral density, and erectile dysfunction. There is little evidence of a link between HPG-axis dysfunction and depressive illness, and exogenous androgens have not been consistently shown to be antidepressant. This article reviews the relationship between androgens and depression in aging men.
For men with a reduced testosterone level, treatment with testosterone usually improves sexual appetency. This has been demonstrated for gel and plaster as well as intramuscular and oral forms of treatment. However, from our current stand point such disturbances in sexual appetency can only be treated pharmacologically if these result from an endocrinological or other disease.
Although guidelines for androgen replacement therapy for older men have been developed by several groups, the data to support treatment are based on the results of only a small number of clinical trials. It has not been definitively established that the decline in testosterone seen in most aging men results in an androgen deficient state with health-related outcomes that can be improved by androgen therapy.