Androgen deficiency is linked with low testosterone levels.

 

Importance of Androgens in Men:

Androgens are secreted by testis and adrenal glands. Androgens play a crucial role in the development and maintenance of male reproductive and sexual functions, body composition, bone health, and behaviour.

 

Reasons for androgen deficiency

Low levels of circulating androgens during pregnancy can cause disturbances in male sexual development, resulting in congenital abnormalities of the male reproductive tract.

 

Testosterone levels decrease slightly as a process of ageing: signs and symptoms caused by this decline can be considered a normal part of ageing. However, low testosterone levels are also associated with obesity and several chronic diseases.

 

Effects of androgen deficiency

• educed fertility
• Sexual dysfunction
• Decreased muscle formation and bone mineralisation
• Disturbances of fat metabolism
• Cognitive dysfunction

Some symptomatic patients may benefit from testosterone replacement

 

Cut off for diagnosing androgen deficiency

Because this syndrome commonly occurs in men who are middle-aged and older, it was termed adult-onset hypogonadism (AOH). European Male Ageing Study states that the prevalence of this is 13.8%. The cut off value of serum testosterone is 300ng/dl and 9.4 U/L for luteinizing hormone (LH).

 

Testosterone replacement therapy and the need for it

When considering (Testosterone replacement therapy) TRT, the goals of therapy should include restoration of testosterone levels to the mid-normal range, approximation of endogenous production, avoidance or reduction of significant adverse effects, and alleviation of the associated signs and symptoms of AOH. Men who are interested in fertility should not be given exogenous testosterone.

There are various preparations and routes of administration of the testosterone. It is available as oral, cutaneous gels, mucosal gels, injections and pellets.