Abstract
Context
Objective
Evidence acquisition
Evidence synthesis
Conclusions
Keywords
1. Introduction
2. Evidence acquisition
3. Evidence synthesis
3.1 Opinion survey on diagnosis of testosterone deficiency syndrome

3.2 Why should we have to treat testosterone deficiency syndrome?
3.2.1 Testosterone and metabolic syndrome
IDF worldwide definition of the metabolic syndrome. International Diabetes Federation Web site. http://www.idf.org/metabolic_syndrome.
IDF worldwide definition of the metabolic syndrome. International Diabetes Federation Web site. http://www.idf.org/metabolic_syndrome.
A waist circumference ≥94 cm plus at least two of the following four factors: | |
Raised triglyceride levels | ≥150 mg/dl or specific treatment for this lipid abnormality |
Reduced HDL cholesterol | <40 mg/dl or specific treatment for this lipid abnormality |
Raised blood pressure | Systolic blood pressure ≥130 mm Hg and/or diastolic blood pressure ≥85 mm Hg or antihypertensive treatment |
Raised fasting plasma glucose | ≥100 mg/dl or previously diagnosed type 2 diabetes |

3.2.2 Testosterone and erectile dysfunction
3.3 Is there a link between testosterone replacement therapy and prostate cancer?
3.4 New perspectives on testosterone treatment
4. Conclusions
Conflicts of interest
Funding support
Acknowledgments
References
- Investigation, treatment, and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA, and ASA recommendations.Eur Urol. 2009; 55: 121-130
- Testosterone deficiency syndrome (TDS) needs to be named appropriately—the importance of accurate terminology.Eur Urol. 2006; 50: 407-409
- Prevalence of symptomatic androgen deficiency in men.J Clin Endocrinol Metab. 2007; 92: 4241-4247
- Testosterone deficiency: a common, unrecognized syndrome.Nat Clin Pract Urol. 2008; 5: 388-396
- Association of specific symptoms and metabolic risks with serum testosterone in older men.J Clin Endocrinol Metab. 2006; 91: 4335-4343
- Hypothalamic-pituitary-testicular axis disruptions in older men are differentially linked to age and modifiable risk factors: the European Male Aging Study.J Clin Endocrinol Med. 2008; 93: 2737-2745
- Low serum testosterone and mortality in male veterans.Arch Intern Med. 2006; 166: 1660-1665
- Prevalence of hypogonadism in males aged at least 45 years: the HIM study.Int J Clin Pract. 2006; 60: 762-769
- Low serum testosterone and mortality in older men.J Clin Endocrinol Metab. 2008; 93: 68-75
IDF worldwide definition of the metabolic syndrome. International Diabetes Federation Web site. http://www.idf.org/metabolic_syndrome.
- Metabolic syndrome: a comprehensive perspective based on interactions between obesity, diabetes, and inflammation.Circulation. 2005; 111: 1448-1454
- Waist circumference and testosterone levels in community dwelling men. The Tromsø study.Eur J Epidemiol. 2004; 19: 657-663
- Effects of androgen deprivation on glycaemic control and on cardiovascular biochemical risk factors in men with advanced prostate cancer with diabetes.Aging Male. 2007; 10: 189-196
- Metabolic syndrome in men with prostate cancer undergoing long-term androgen-deprivation therapy.J Clin Oncol. 2006; 24: 3979-3983
- Androgens stimulate myogenic differentiation and inhibit adipogenesis in C3H 10T1/2 pluripotent cells through an androgen receptor-mediated pathway.Endocrinology. 2003; 144: 5081-5088
- Effects of testosterone on body composition, bone metabolism and serum lipid profile in middle-aged men: a meta-analysis.Clin Endocrinol (Oxf). 2005; 63: 280-293
- Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolaemia in hypogonadal men with type 2 diabetes.Eur J Endocrinol. 2006; 154: 899-906
- Androgen treatment of abdominally obese men.Obes Res. 1993; 1: 245-251
- Prevalence of androgen deficiency in men with erectile dysfunction.Urology. 2008; 71: 693-697
- Testosterone and erectile dysfunction.J Androl. 2008; 29: 593-604
- Effects of testosterone on erectile function: implications for the therapy of erectile dysfunction.BJU Int. 2007; 99: 988-992
- Role of androgens in erectile function.J Urol. 2004; 171 (quiz 2435): 2358-2362
- Combining testosterone and PDE5 inhibitors in erectile dysfunction: basic rationale and clinical evidences.Eur Urol. 2006; 50: 940-947
- Testosterone and erectile function: from basic research to a new clinical paradigm for managing men with androgen insufficiency and erectile dysfunction.Eur Urol. 2007; 52: 54-70
- The evolving role of testosterone in the treatment of erectile dysfunction.Int J Clin Pract. 2006; 60: 1087-1092
- Does sildenafil combined with testosterone gel improve erectile dysfunction in hypogonadal men in whom testosterone supplement therapy alone failed?.J Urol. 2005; 173: 530-532
- Erectile dysfunction and testosterone deficiency.Front Horm Res. 2009; 37: 108-122
- Diagnosing and treating testosterone deficiency in different parts of the world. Results from global market research.Aging Male. 2007; 10: 173-181
- Studies on prostatic cancer. I. The effect of castration, of estrogen and of androgen injection on serum phosphatases in metastatic carcinoma of the prostate.Cancer Res. 1941; 1: 293-297
- Studies on prostatic cancer. II. The effects of castration on advanced carcinoma of the prostate gland.Arch Surg. 1941; 43: 209-223
- Testosterone and prostate cancer: an historical perspective on a modern myth.Eur Urol. 2006; 50: 935-939
- Testosterone replacement therapy and prostate cancer.Urol Clin North Am. 2007; 34 (vii): 555-563
- Shifting the paradigm of testosterone and prostate cancer: the saturation model and the limits of androgen-dependent growth.Eur Urol. 2009; 55: 310-321
- Androgen-induced differentiation and tumorigenicity of human prostate epithelial cells.Cancer Res. 2004; 64: 8867-8875
- The androgen receptor and prostate cancer invasion.Mol Cell Endocrinol. 2006; 246: 157-162
- Immune modulation and increased neurotrophic factor production in multiple sclerosis patients treated with testosterone.J Neuroinflammation. 2008; 5: 32
- Neuroprotective role of testosterone in the nervous system.Pol J Pharmacol. 2004; 56: 509-518
- Long-term pharmacokinetics of transdermal testosterone gel in hypogonadal men.J Clin Endocrinol Metab. 2000; 85: 4500-4510
- Pharmacokinetic study of a new testosterone-in-adhesive matrix patch applied every 2 days to hypogonadal men.J Steroid Biochem Mol Biol. 2008; 109: 177-184
- Efficacy and safety of a new testosterone-in-adhesive matrix patch applied every 2 days for 1 year to hypogonadal men.J Steroid Biochem Mol Biol. 2008; 109: 168-176