Available online 22 April 2022, 101662
In this narrative review we provide an overview of the current literature on male hypogonadism and related comorbidities, also depicting the role of testosterone therapy (TTh) in the various settings. Male hypogonadism has been associated with major comorbidities such as type 2 diabetes mellitus, obesity and cardiovascular diseases, promoting a vicious cycle that may lead to further hypogonadism. The biological underpinnings of this association are currently under investigations, but clearly emerges the relevance of the hypothalamic-pituitary–gonadal axis. Hypogonadism has also been associated with increased risk of mortality. As such, TTh has the potential to oppose these patterns and improve cardiovascular and metabolic health in hypogonadal men. Clinical and observational data suggest that in males with hypogonadism, TTh, together with lifestyle changes and diabetes medications, may improve glycemia, reduce risk of progression to diabetes and provides positive effects on cardiovascular risk. Conversely, available data does not fully support any increased risk of prostate cancer in men under TTh. Of clinical relevance, a possible harmful role of hypogonadal status in men with COVID-19 eventually emerged.
Keywordshypogonadism
testosterone
cardiovascular
mortality
diabetes
COVID-19
AbbreviationsLOHlate onset hypogonadism
SARS-CoV-2severe acute respiratory syndrome coronavirus 2
MACEmajor adverse cardiac events
COVID-19severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced disease
RCTrandomized control trial
T2DMdiabetes mellitus type 2
FSHfollicle stimulating hormone
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