journal of men's health
Volume 6, Issue 3 , Pages 210-218 , September 2009

Recognising late-onset hypogonadism: a difficult task for sexual health care

  • G. Corona, MD

      Affiliations

    • Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; Endocrinology Unit, Maggiore-Bellaria Hospital, Bologna, Italy
    • ,
  • N. Ferruccio, MD

      Affiliations

    • Andrology Unit, Department of Clinical Physiopathology, University of Florence, Italy
    • ,
  • S. Morittu, MD

      Affiliations

    • Endocrinology Unit, Maggiore-Bellaria Hospital, Bologna, Italy
    • ,
  • G. Forti, MD

      Affiliations

    • Andrology Unit, Department of Clinical Physiopathology, University of Florence, Italy
    • ,
  • M. Maggi, MD

      Affiliations

    • Andrology Unit Department of Clinical Physiopathology, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
    • Corresponding Author InformationCorresponding author.

Received 16 April 2009 ,Accepted 22 May 2009.

References 

  1. Courtenay WH, Keeling RP. Men, gender, and health: toward an interdisciplinary approach. J Am Coll Health. 2000;48:243
  2. Laughlin GA, Barrett-Connor E, Bergstrom J. Low serum testosterone and mortality in older men. J Clin Endocrinol Metab. 2008;93:68–75
  3. Khaw KT, Dowsett M, Folkerd E, Bingham S, Wareham N, Luben R, et al. Endogenous testosterone and mortality due to all causes, cardiovascular disease, and cancer in men: European Prospective Investigation into Cancer in Norfolk (EPIC-Norfolk) Prospective Population Study. Circulation. 2007;16:2694–2701
  4. Wu FC, Tajar A, Pye SR, Silman AJ, Finn JD, O’Neill TW, et al. European Male Aging Study Group 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 Metab. 2008;93:2737–2745
  5. Ferrini RL, Barrett-Connor E. Sex hormones and age: a cross-sectional study of testosterone and estradiol and their bioavailable fractions in community-dwelling men. Am J Epidemiol. 1998;147:750–754
  6. Gray A, Feldman HA, McKinlay JB, Longcope C. Age, disease, and changing sex hormone levels in middle-aged men: results of the Massachusetts Male Aging Study. J Clin Endocrinol Metab. 1991;73:1016–1025
  7. Muller M, den Tonkelaar I, Thijssen JH, Grobbee DE, van der Schouw YT. Endogenous sex hormones in men aged 40-80 years. Eur J Endocrinol. 2003;149:583–589
  8. van den Beld AW, de Jong FH, Grobbee DE, Pols HA, Lamberts SW. Measures of bioavailable serum testosterone and estradiol and their relationships with muscle strength, bone density, and body composition in elderly men. J Clin Endocrinol Metab. 2000;85:3276–3282
  9. Orwoll E, Lambert LC, Marshall LM, Phipps K, Blank J, Barrett-Connor E, et al. Testosterone and estradiol among older men. J Clin Endocrinol Metab. 2006;91:1336–1344
  10. Maggi M, Schulman C, Quinton R, Langham S, Uhl-Hochgraeber K. The burden of testosterone deficiency syndrome in adult men: economic and quality-of-life impact. J Sex Med. 2007;4(1):1056–1069
  11. Morelli A, Corona G, Filippi S, Ambrosini S, Forti G, Vignozzi L, et al. Which patients with sexual dysfunction are suitable for testosterone replacement therapy?. J Endocrinol Invest. 2007;30:880–888
  12. Wang C, Nieschlag E, Swerdloff R, Behre HM, Hellstrom WJ, Gooren LJ, et al. Investigation, treatment, and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA, and ASA Recommendations. Eur Urol 2008 Aug 30. [Epub ahead of print]
  13. Corona G, Mannucci E, Forti G, Maggi M. Hypogonadism, ED, metabolic syndrome and obesity: a pathological link supporting cardiovascular diseases. Int J Androl 2009 Feb 10. [Epub ahead of print]
  14. Corona G, Mannucci E, Ricca V, Lotti F, Boddi V, Bandini E, et al. The age-related decline of testosterone is associated with different specific symptoms and signs in patients with sexual dysfunction. Int J Androl 2009 Feb 10. [Epub ahead of print]
  15. Corona G, Mannucci E, Petrone L, Balercia G, Fisher AD, Chiarini V, et al. ANDROTEST: a structured interview for the screening of hypogonadism in patients with sexual dysfunction. J Sex Med. 2006;3:706–715
  16. Corona G, Mannucci E, Mansani R, Petrone L, Bartolini M, Giommi R, et al. Aging and pathogenesis of erectile dysfunction. Int J Impot Res. 2004;16:395–402
  17. Zitzmann M, Faber S, Nieschlag E. Association of specific symptoms and metabolic risks with serum testosterone in older men. J Clin Endocrinol Metab. 2006;91:4335–4343
  18. Fisher AD, Corona G, Bandini E, Mannucci E, Lotti F, Boddi V, et al. Psychobiological correlates of extramarital affairs and differences between stable and occasional infidelity among men with sexual dysfunctions. J Sex Med. 2009;6:866–875
  19. Bell RR, Turner S, Rosen L. A multivariate analysis of female extramarital coitus. J Marriage Fam. 1975;37:375–384
  20. Treas J, Giesen D. Sexual infidelity among married and cohabiting Americans. J Marriage Fam. 2000;62:48–60
  21. Van Anders SM, Hamilton LD, Watson NV. Multiple partners are associated with higher testosterone in North American men and women. Horm Behav. 2007;51:454–459
  22. Christiansen K. Behavioural correlates of testosterone. In:  Nieschlag E,  Behre HM editor. Testosterone: Action Deficiency Substitution. 3rd edition.. Cambridge: Cambridge University Press; 2004;p. 125–173
  23. Corona G, Jannini EA, Mannucci E, Fisher AD, Lotti F, Petrone L, et al. Different testosterone levels are associated with ejaculatory dysfunction. J Sex Med. 2008;5:1991–1998
  24. Corona G, Mannucci E, Petrone L, Fisher AD, Balercia G, De Scisciolo G, et al. Psychobiological correlates of delayed ejaculation in male patients with sexual dysfunctions. J Androl. 2006;27:453–458
  25. O’Connor DB, Corona G, Forti G, Tajar A, Lee DM, Finn JD, et al. Assessment of sexual health in aging men in Europe: development and validation of the European Male Ageing Study sexual function questionnaire. J Sex Med. 2008;5:1374–1385
  26. Knussmann R, Christiansen K, Couwenbergs C. Relations between sex hormone levels and sexual behavior in men. Arch Sex Behav. 1986;15:429–445
  27. Corona G, Petrone L, Mannucci E, Ricca V, Balercia G, Giommi R, et al. The impotent couple: low desire. Int J Androl. 2005;28(Suppl 2):46–52
  28. Corona G, Mannucci E, Petrone L, Giommi R, Mansani R, Fei L, et al. Psycho-biological correlates of hypoactive sexual desire in patients with erectile dysfunction. Int J Impot Res. 2004;16:275–281
  29. Vignozzi L, Corona G, Petrone L, Filippi S, Morelli AM, Forti G, et al. Testosterone and sexual activity. J Endocrinol Invest. 2005;28(3 Suppl):39–44
  30. Carani C, Bancroft J, Granata A, Del Rio G, Marrama P. Testosterone and erectile function, nocturnal penile tumescence and rigidity, and erectile response to visual erotic stimuli in hypogonadal and eugonadal men. Psychoneuroendocrinology. 1992;17:647–654
  31. Granata AR, Rochira V, Lerchl A, Marrama P, Carani C. Relationship between sleep-related erections and testosterone levels in men. J Androl. 1997;18:522–527
  32. Montorsi F, Oettel M. Testosterone and sleep-related erections: an overview. J Sex Med. 2005;2:771–784
  33. Dettenhofer MH. Eunuchs, women and imperial courts. In:  Sheidel W editors. Rome and China: Comparative Perspective Ancient World Empire.. Oxford: Oxford University Press; 2009;p. 83–89
  34. Shabsigh R. Testosterone therapy in erectile dysfunction and hypogonadism. J Sex Med. 2005;2:785–792
  35. Rhoden EL, Teloken C, Sogari PR, Souto CA. The relationship of serum testosterone to erectile function in normal aging men. J Urol. 2002;167:1745–1748
  36. Morelli A, Filippi S, Mancina R, Luconi M, Vignozzi L, Marini M, et al. Androgens regulate phosphodiesterase type 5 expression and functional activity in corpora cavernosa. Endocrinology. 2004;145:2253–2263
  37. Traish AM, Park K, Dhir V, Kim NN, Moreland RB, Goldstein I. Effects of castration and androgen replacement on erectile function in a rabbit model. Endocrinology. 1999;140:1861–1868
  38. Traish AM, Guay A, Feeley R, Saad F. The dark side of testosterone deficiency: I. Metabolic syndrome and erectile dysfunction. J Androl. 2009;30:10–22
  39. Isidori AM, Giannetta E, Gianfrilli D, Greco EA, Bonifacio V, Aversa A, et al. Effects of testosterone on sexual function in men: results of a meta-analysis. Clin Endocrinol (Oxf). 2005;63:381–394
  40. Corona G, Mannucci E, Jannini EA, Lotti F, Ricca V, Monami M, et al. Hypoprolactinemia: a new clinical syndrome in patients with sexual dysfunction. J Sex Med. 2009;6(5):1457–1466
  41. Svartberg J. Epidemiology: testosterone and the metabolic syndrome. Int J Impot Res. 2007;19:124–128
  42. Corona G, Mannucci E, Schulman C, Petrone L, Mansani R, Cilotti A, et al. Psychobiologic correlates of the metabolic syndrome and associated sexual dysfunction. Eur Urol. 2006;50:595–604
  43. Corona G, Mannucci E, Petrone L, Balercia G, Paggi F, Fisher AD, et al. NCEP-ATPIII-defined metabolic syndrome, type 2 diabetes mellitus, and prevalence of hypogonadism in male patients with sexual dysfunction. J Sex Med. 2007;4(1):1038–1045
  44. Corona G, Mannucci E, Petrone L, Schulman C, Balercia G, Fisher AD, et al. A comparison of NCEP-ATPIII and IDF metabolic syndrome definitions with relation to metabolic syndrome-associated sexual dysfunction. J Sex Med. 2007;4:789–796
  45. Guay AT. The emerging link between hypogonadism and metabolic syndrome. J Androl. 2009;30:370–376
  46. Corona G, Mannucci E, Fisher AD, Lotti F, Petrone L, Balercia G, et al. Low levels of androgens in men with erectile dysfunction and obesity. J Sex Med. 2008;5:2454–2463
  47. Grundy SM. Metabolic syndrome: a multiplex cardiovascular risk factor. J Clin Endocrinol Metab. 2007;92:399–404
  48. Stellato RK, Feldman HA, Hamdy O, Horton ES, McKinlay JB. Testosterone, sex hormone-binding globulin, and the development of type 2 diabetes in middle-aged men: prospective results from the Massachusetts male aging study. Diabetes Care. 2000;23:490–494
  49. Laaksonen DE, Niskanen L, Punnonen K, Nyyssonen K, Tuomainen TP, Valkonen VP, et al. The metabolic syndrome and smoking in relation to hypogonadism in middle-aged men: a prospective cohort study. J Clin Endocrinol Metab. 2005;90:712–719
  50. Laaksonen DE, Niskanen L, Punnonen K, Nyyssonen K, Tuomainen TP, Salonen R, et al. Sex hormones, inflammation and the metabolic syndrome: a population-based study. Eur J Endocrinol. 2003;149:601–608
  51. Oh JY, Barrett-Connor E, Wedick NM, Wingard DL Rancho Bernardo Study. Endogenous sex hormones and the development of type 2 diabetes in older men and women: the Rancho Bernardo study. Diabetes Care. 2002;25:55–60
  52. Kupelian V, Page ST, Araujo AB, Travison TG, Bremner WJ, McKinlay JB. Low sex hormone-binding globulin, total testosterone, and symptomatic androgen deficiency are associated with development of the metabolic syndrome in non obese men. J Clin Endocrinol Metab. 2006;91:843–850
  53. Pitteloud N, Hardin M, Dwyer AA, Valassi E, Yialamas M, Elahi D, et al. Increasing insulin resistance is associated with a decrease in Leydig cell testosterone secretion in men. J Clin Endocrinol Metab. 2005;90:2636–2641
  54. Pitteloud N, Dwyer AA, Decruz S, Lee H, Boepple PA, Crowley WF, et al. Inhibition of LH secretion by testosterone in men requires aromatization for its pituitary but not its hypothalamic effects: evidence from the tandem study of normal and gonadotrophin-releasing hormone-deficient men. J Clin Endocrinol Metab. 2008;93:784–791
  55. Derby CA, Zilber S, Brambilla D, Morales KH, McKinlay JB. Body mass index, waist circumference and waist to hip ratio and change in sex steroid hormones: the Massachusetts Male Ageing Study. Clinical Endocrinol (Oxf). 2006;65:125–131
  56. Maggi M. Gender differences mirrored: andro-pause, a palindromic meno-pause or just a lean pause?. J Sex Med. 2008;5:2243–2245
  57. Niskanen L, Laaksonen DE, Punnonen K, Mustajoki P, Kaukua J, Rissanen A. Changes in sex hormone-binding globulin and testosterone during weight loss and weight maintenance in abdominally obese men with the metabolic syndrome. Diabetes Obes Metab. 2004;6:208–215
  58. Kaukua J, Pekkarinen T, Sane T, Mustajoki P. Sex hormones and sexual function in obese men losing weight. Obes Res. 2003;11:689–694
  59. Corona G, Fagioli G, Mannucci E, Romeo A, Rossi M, Lotti F, et al. Penile doppler ultrasound in patients with erectile dysfunction (ED): role of peak systolic velocity measured in the flaccid state in predicting arteriogenic ED and silent coronary artery disease. J Sex Med. 2008;5:2623–2634
  60. Aversa A, Isidori AM, Spera G, Lenzi A, Fabbri A. Androgens improve cavernous vasodilation and response to sildenafil in patients with erectile dysfunction. Clin Endocrinol (Oxf). 2003;58:632–638
  61. Foresta C, Caretta N, Rossato M, Garolla A, Ferlin A. Role of androgens in erectile function. J Urol. 2004;171(6 Pt 1):2358–2362
  62. Wu FCW, von Eckardstein A. Androgens and coronary artery disease. End Rev. 2003;24:183–217
  63. Araujo AB, Kupelian V, Page ST, Handelsman DJ, Bremner WJ, McKinlay JB. Sex steroids and all-cause and cause-specific mortality in men. Arch Int Med. 2007;167:1252–1260
  64. Smith GD, Ben-Shlomo Y, Beswick A, Yarnell J, Lightman S, Elwood P. Cortisol, testosterone, and coronary heart disease: prospective evidence from the Caerphilly study. Circulation. 2005;112:332–340
  65. Corona G, Ricca V, Bandini E, Mannucci E, Petrone L, Fisher AD, et al. Association between psychiatric symptoms and erectile dysfunction. J Sex Med. 2008;5:458–468
  66. Shiri R, Koskimäki J, Tammela TL, Häkkinen J, Auvinen A, Hakama M. Bidirectional relationship between depression and erectile dysfunction. J Urol. 2007;177:669–673
  67. Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS, et al. Testosterone therapy in adult men with androgen deficiency syndromes: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2006;91:1995–2010
  68. Seidman SN, Spatz E, Rizzo C, Roose SP. Testosterone replacement therapy for hypogonadal men with major depressive disorder: a randomized, placebo-controlled clinical trial. J Clin Psychiatry. 2001;62:406–412
  69. T'Sjoen GG, De Vos S, Goemaere S, Van Pottelbergh I, Dierick M, Van Heeringen C, et al. Sex steroid level, androgen receptor polymorphism, and depressive symptoms in healthy elderly men. J Am Geriatr Soc. 2005;53:636–642
  70. Shores MM, Sloan KL, Matsumoto AM, Moceri VM, Felker B, Kivlahan DR. Increased incidence of diagnosed depressive illness in hypogonadal older men. Arch Gen Psychiatry. 2004;61:162–167
  71. Wang C, Cunningham G, Dobs A, Iranmanesh A, Matsumoto AM, Snyder PJ, et al. Long-term testosterone gel (AndroGel) treatment maintains beneficial effects on sexual function and mood, lean and fat mass, and bone mineral density in hypogonadal men. J Clin Endocrinol Metab. 2004;89:2085–2098
  72. Orengo CA, Fullerton L, Kunik ME. Safety and efficacy of testosterone gel 1% augmentation in depressed men with partial response to antidepressant therapy. J Geriatr Psychiatry Neurol. 2005;18:20–24
  73. Corona G, Ricca V, Bandini E, Mannucci E, Lotti F, Boddi V, et al. Selective serotonin reuptake inhibitor-induced sexual dysfunction. J Sex Med. 2009;6(5):1259–1269
  74. Morley JE, Charlton E, Patrick P, Kaiser FE, Cadeau P, McCready D, et al. Validation of a screening questionnaire for androgen deficiency in aging males. Metabolism. 2000;49:1239–1242
  75. Heinemann LA, Saad F, Heinemann K, Thai DM. Can results of the Aging Males’ Symptoms (AMS) scale predict those of screening scales for androgen deficiency?. Aging Male. 2004;7:211–218
  76. Smith KW, Feldman HA, McKinlay JB. Construction and field validation of a self-administered screener for testosterone deficiency (hypogonadism) in ageing men. Clin Endocrinol (Oxf). 2000;53:703–711
  77. Morley JE, Perry HM, Kevorkian RT, Patrick P. Comparison of screening questionnaires for the diagnosis of hypogonadism. Maturitas. 2006;53(4):424–429
  78. Corona G, Jannini EA, Maggi M. Inventories for male and female sexual dysfunctions. Int J Impot Res. 2006;18:236–250
  79. Travison TG, Shackelton R, Araujo AB, Hall SA, Williams RE, Clark RV, et al. The natural history of symptomatic androgen deficiency in men: onset, progression, and spontaneous remission. J Am Geriatr Soc. 2008;56:831–839

PII: S1875-6867(09)00067-0

doi: 10.1016/j.jomh.2009.05.002

journal of men's health
Volume 6, Issue 3 , Pages 210-218 , September 2009

Article Tools

* Image Usage & Resolution