Functional Hypogonadism in Middle-Aged and Older Men: Testosterone Treatment or not?

Abstract

Clinicians commonly encounter middle-aged and older men who present with functional hypogonadism, i.e. with clinical features compatible with androgen deficiency and lowered serum testosterone, but without evidence of organic hypothalamic-pituitary-testicular axis pathology. Whether, and when, testosterone therapy should be offered to such men remains uncertain and controversial, in part due to lack of definitive evidence regarding long term patient-important health outcomes with testosterone treatment. In this debate, we address this controversy and provide two opposing point of views on the role of testosterone treatment in older men with functional hypogonadism.