Male Late-Onset Hypogonadism (LOH) – Current Concepts and Controversies

Journal für Reproduktionsmedizin und Endokrinologie - Journal of Reproductive Medicine and Endocrinology 2015; 12 (4): 388-391

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Keywords: ageing,  Andropause,  late-onset hypogonadism,  LOH,  serum testosterone,  sexual function,  testosterone replacement therapy,  TRT

Late-onset hypogondism (LOH), also called andropause, or by the misnomer ‘male menopause’, is a situation where a middle-aged or older man has lowered serum testosterone (T) concentration in conjunction with diffuse symptoms, reminiscent of those of genuine male hypogonadism (e.g. reduced sexual function, loss of vigor, muscle weakness, depression). Similar symptoms are common in ageing men with no other specific reason. There is considerable uncertainty about the diagnostic criteria, prevalence and treatment options of LOH even amongst experts. We review here some salient findings on the prevalence, diagnostic criteria, impact on health, and treatment options of LOH, as well as the current controversies concerning T replacement therapy of LOH.