Late-onset hypogonadism. Diagnostical and treatment landmarks

Late-onset hypogonadism (LOH) is the most controversial form of hypogonadism and an unsolved problem. Its prevalence is unknown, it is estimated as being at least 1 in 5 men after 40 years, and about 80% of those with comorbidities may have hypogonadism. LOH does not have age-defined criteria and may be included in its start-out and developing mechanisms elements of primary hypogonadism due to insufficient testicular function and secondary. When preparing this article, the reviews of 40 analytical studies and international guidelines of the European Academy of Andrology and the Societies of Endocrinology and Urology were consulted. This type of hypogonadism is dependent on the age and men’s health status. Decreased testosterone levels can be the result of chronic disease, diabetes, organ failure, or obesity. Or because of the presence of chronic systemic inflammation. Older patients with signs of testosterone deficiency need an individual approach to establish the presence of a reversible/ functional form of hypogonadism that can be ameliorated with other remedies than testosterone replacement therapy. After clinical and biochemical confirmation of hypogonadism, testosterone treatment recommended recommended only with an evaluation of potential benefits and risks.