Child ; Humans ; Consensus ; Hypogonadism/drug therapy*

Late-onset hypogonadism (LOH) is a clinical and bio-chemical syndrome associated with advancing age in males and seriously affects the quality of life of some of the patients. A classical therapeutic option for LOH is testosterone supplementary treatment (TST). Its effectiveness has been verified, whereas its long-term safety remains to be further evaluated. With deeper insights into LOH, many new therapeutic strategies have been proposed, which include the treatments with gonadotropins, testosterone precursors (such as dehydroepiandrosterone [DHEA]), non-aromatizable androgens (such as dihydrotestosterone [DHT]), antiestrogens (such as aromatase inhibitors and estrogen receptor antagonists), and Chinese medicine. Meanwhile, studies on the transplantation of Leydig stem cells, selective androgen receptor modulators (SARMs), and selective estrogen receptor beta (ERbeta) agonists have shed new light on the treatment of LOH.
Humans ; Hypogonadism ; drug therapy ; surgery ; therapy ; Male ; Testosterone ; therapeutic use

Humans ; Hypogonadism/drug therapy* ; Male ; Puberty ; Puberty, Delayed ; Treatment Outcome

With the approaching of an aging society, the number of patients with late-onset hypogonadism (LOH) is increasing. There are various methods for the treatment of LOH. And testosterone undecanoate is an effective and safe supplementary therapy for LOH. This paper gives an overview of the advances in the studies of testosterone undecanoate in the treatment of LOH.
Erectile Dysfunction ; drug therapy ; Humans ; Hypogonadism ; drug therapy ; Male ; Testosterone ; analogs & derivatives ; therapeutic use

Male hypogonadism is a group of syndromes in clinic andrology characterized by complete or partial androgen deficiency. It can be divided into primary and secondary hypogonadism. Besides the etiological treatment, androgen replacement therapy should be adopted in all patients of primary hypogonadism and patients of secondary hypogonadism who do not have the need of having a child. For patient's benefits, androgen should be used and selected properly as there are so many androgen preparation at present.
Androgens ; administration & dosage ; deficiency ; therapeutic use ; Hormone Replacement Therapy ; Humans ; Hypogonadism ; drug therapy ; Male

Androgens, which constitute the basis of male health, have a wide variety of physiological functions. Clinically, external testosterones are often prescribed for patients with hypogonadism to supplement their insufficiency in self-secretion. Testosterone supplemental therapy (TST) can raise the levels of internal androgens, relieve the related clinical symptoms, and improve the patients' life quality. Meanwhile, TST also works on multiple organs and systems, and have some effectiveness for a given period of time.
Hormone Replacement Therapy ; Humans ; Hypogonadism ; drug therapy ; Male ; Testosterone ; administration & dosage ; therapeutic use

To assess the impact of hypogonadism on bone mineral density, we performed a cross-sectional study of 70 amenorrheic women, comprising 22 cases of gonadal dysgenesis and 48 cases of isolated hypogonadotropic hypogonadism (IHH). Bone mineral density was measured by DEXA at four sites: the femur neck, Ward's triangle, trochanter, and lumbar spine (L2-4). The results were compared to those of a control group consisting of 60 age-matched, normal-cycling women. Bone mineral densities around age 20 were already significantly lower at all four sites in patients with IHH and gonadal dysgenesis when compared with controls, suggesting that these patients failed to achieve peak bone mass during pubertal development. In patients with IHH, the initial BMD around age 18-20 were significantly lower at all four sites and the decrease in bone density continued rapidly during the early twenties up to age 25, and then it slowed markedly thereafter. Bone biochemical marker, ICTP and osteocalcin were significantly negatively correlated with age and remained increased until age 40, which was reminiscent of menopausal bone loss pattern such as high bone turn-over in the early twenties, followed by slow bone loss in the late twenties. In patients with gonadal dysgenesis, bone biochemical marker, ICTP and osteocalcin were also significantly negative correlated with age and remained increased until age 40, but no significant changes in BMD were noted as a function of age, which may be attributed to the small sample size and slow bone loss. These findings suggest that the initiation of prompt and timely therapeutic intervention as early as possible in the menarchal period and throughout the remainder of life, particularly during the period associated with rapid bone loss.
Adolescence ; Adult ; Bone Density* ; Collagen/analysis ; Female ; Gonadal Dysgenesis/therapy ; Gonadal Dysgenesis/metabolism* ; Human ; Hypogonadism/therapy ; Hypogonadism/metabolism* ; Osteocalcin/blood ; Peptides/analysis ; Puberty

Androgen deficiency in aging male has become a topic of increasing interest and debate throughout the world. The past decade has brought evidence that androgen treatment of hypogonadal men has benefits for multiple target organs. It is recognized that significant alterations in many endocrine systems occur in association with aging, but the significance of these changes is not well understood. In addition to its role in specific organ systems, testosterone has been found to play a role in the pathogenesis of metabolic syndrome and endothelial dysfunction. Based on data from the last 20 years, the syndrome previously called PADAM(partial androgen deficiency in aging male) is now referred to as LOH(late-onset hypogonadism), as recommended by the ISA(International Society of Andrology) at the 4th ISSAM Congress in 2004. LOH is a clinical and biochemical syndrome associated with advancing age and characterized by a set of typical symptoms accompanied by a deficiency in serum testosterone. Diagnostic tools for LOH, long-term data on the effects of testosterone replacement in aging men, and specific risk data for the prostate and cardiovascular systems are still limited. However, we have seen the recent development of a more effective and safe formulation of testosterone, e.g., Testogel 1% and a long-acting testosterone undecanoate injectable. Until better methods for caring LOH are refined, the urologists should be alert and stay current with the updates from the academic societies.
Aging ; Cardiovascular System ; Endocrine System ; Hormone Replacement Therapy ; Humans ; Hypogonadism* ; Male* ; Prostate ; Testosterone

The combination of Müllerian agenesis with inguinal ovaries accompanied by primary ovarian insufficiency is extremely rare. A 21-year-old Korean woman was referred to our center with primary amenorrhea. The patient was diagnosed with Müllerian agenesis with inguinal ovaries. Her hormonal profile showed hypergonadotrophic hypogonadism suggesting primary ovarian insufficiency. We performed laparoscopic neovaginoplasty using modified Davydov's procedure and reposition inguinal ovaries in the pelvic cavity. Oral estrogen replacement was applied for the treatment of primary ovarian insufficiency. This is a rare case report on Mayer-Rokitansky-Kuster-Hauser syndrome accompanied not only by inguinal ovaries but also with primary ovarian insufficiency. We present our first experience on the laparoscopic neovaginoplasty performed on the patient with müllerian agenesis accompanied by inguinal ovaries and primary ovarian insufficiency.
Amenorrhea ; Estrogen Replacement Therapy ; Female ; Humans ; Hypogonadism ; Laparoscopy ; Ovary* ; Peritoneum* ; Primary Ovarian Insufficiency* ; Young Adult

Testosterone is the principal androgen in the human male. The decline of testosterone with aging was recognized to be associated with a number of symptoms and signs that reduce the quality of life and that may even have severe, debilitating consequences. Clinically, late-onset hypogonadism (LOH) is diagnosed by use of biochemical and clinical measures. Despite published guidelines and recommendations, however, uncertainty surrounds the profile of clinical symptoms as well as the biochemical threshold of diagnosis. Clinicians should be aware of these shortcomings while adhering to the guidelines. Current treatment methods are centered on restoring testosterone to mid to lower levels of young men with natural testosterone replacements. Although recent studies have highlighted possible additional benefits involving improvement of systemic disorders, the goal of treatment is to improve sexual function, while observing for adverse effects in the prostate. Overall, the problem of LOH in debilitating the quality of life and well-being is real, and by following proper guidelines with attentiveness to the results of treatment trials, testosterone replacement therapy presents a safe and effective treatment option.
Aging ; Erectile Dysfunction ; Hormone Replacement Therapy ; Humans ; Hypogonadism ; Libido ; Male ; Prostate ; Quality of Life ; Testosterone ; Uncertainty