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Endocrine Abstracts (2023) 90 N2.2 | DOI: 10.1530/endoabs.90.N2.2

ECE2023 Nurse Sessions Hypogonadism: Causes, consequences, consensus and controversies (4 abstracts)

Consequences: Hypogonadism and sexual dysfunction, Hypogonadism and bone health, Hypogonadism and anaemia, Hypogonadism and cardiovascular risk

Giulia Rastrelli

Department of Experimental and Clinical Biomedical Sciences, Andrology, Women’s Endocrinology and Gender Incongruence Unit, Careggi Hospital, University of Florence, Florence, Italy

Testosterone (T) declines with ageing and chronic diseases, including obesity and metabolic conditions. This results in T levels in the hypogonadal range in up to 15% of middle-aged elderly men from European general population. These are at risk to develop the clinical consequences of decreased T. Low T is associated with reduced sexual desire, erectile dysfunction and orgasmic impairment. Restoring T levels using T replacement therapy is able to improve the symptoms. However, it is pivotal to understand that not only low T but also ageing and comorbidities have a role in inducing sexual dysfunction. Therefore, a careful assessment is necessary to discern the underlying risk factors and to decide the appropriate treatment. In fact, particularly for erectile dysfunction, the benefits of T therapy are eroded by the detrimental effect of metabolic disorders. Men with low T are at higher risk for cardiovascular events. The underlying mechanisms are deemed to be multiple and only partially known. Whether the treatment is beneficial is still unclear and some data suggest that it may be even detrimental. In the last decade, several studies have been published showing an association between T treatment and adverse cardiovascular outcomes. However, these studies have been criticized for several flaws. Current evidence form meta-analyses suggest a neutral effect of T treatment on cardiovascular events. A known consequence of low T reduced bone mass and osteoporosis. T therapy is able to restore bone mass. However, data showing that T treatment is able to reduce risk of bone fractures are currently lacking.

Volume 90

25th European Congress of Endocrinology

Istanbul, Turkey
13 May 2023 - 16 May 2023

European Society of Endocrinology 

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