Late‐onset hypogonadism and lifestyle‐related metabolic disorders

Abstract

Background Late‐onset hypogonadism (LOH) is a condition defined by low levels of testosterone (T), occurring in advanced age. LOH is promoted by senescence, which, in turn, has negative effects on male fertility. Interestingly, the impact of metabolic disorders on the male reproductive system has been the topic of several studies, but the association with LOH is still debatable. Objectives Herein, we discuss the hypothesis that the prevalence of metabolic abnormalities potentiates the effects of LOH on the male reproductive system, affecting the reproductive potential of those individuals. Material and methods We analyzed the bibliography available, until June 2019, about LOH in relation to metabolic and hormonal dysregulation, sperm quality profiles and assisted‐reproduction treatment outcomes. Results LOH affects the hypothalamic‐pituitary testis (HPT) axis. Additionally, metabolic disorders can also induce T deficiency, which is reflected in decreased male fertility, highlighting a possible connection. Indeed, T replacement therapy (TRT) is widely used to restore T levels. Although this therapy is unable to reverse all deleterious effects promoted by LOH on male reproductive function, it can improve metabolic and reproductive health. Discussion and Conclusions Emerging new evidence suggests that metabolic disorders may aggravate LOH effects on the fertility potential of males in reproductive age, by enhancing T deficiency. These results clearly show that metabolic disorders, such as obesity and diabetes, have a greater impact on causing hypogonadotropic hypogonadism than tissue senescence. Further, TRT and off‐label alternatives capable of restoring T levels appear as suitable to improve LOH, while also counteracting comorbidities related with metabolic diseases.

Low Serum Dehydroepiandrosterone and Dehydroepiandrosterone Sulfate Are Associated With Coronary Heart Disease in Men With Type 2 Diabetes Mellitus

“…Among women, the associations of DHEA and DHEAS with CVD have also been found to be inconsistent (11)(12)(13). Additionally, diabetes has adverse effects on the reproductive system and sex hormones and increases the frequency of hypogonadism (14,15). The risk of CVD among patients with diabetes is twice that of non-diabetic men and three times that of non-diabetic women (16).…”

Age-Related Testosterone Deficiency Merits Treatment

“…These include obesity, diabetes, and metabolic syndrome and opioid use, among others. 40,[67][68][69][70][71][72][73][74][75][76][77][78][79][80] Therefore, it is irrational to dismiss these newly described conditions and advocate against TTh under the guise of ''age-related'' TD. Moreover, in the clinical setting, ''age-related'' or ''idiopathic'' TD is among the most common etiology noted.…”

Association between hypertriglyceridemic waist phenotype and hypogonadism in Taiwanese adult men

“…Male hypogonadism is characterized by a deficiency of testosterone, a critical hormone required for sexual, cognitive, and body functions and development [ 1 ]. Studies have found that testosterone deficiency not only affects the quality of life but also increases the risk of erectile dysfunction, metabolic syndrome, diabetes, osteoporosis, fracture, and cardiovascular disease [ 2 – 7 ]. Studies have also reported that middle-aged and elderly men with low testosterone levels have increased overall mortality and cardiovascular disease mortality rates in long-term follow-up [ 8 – 12 ].…”