Androgen therapy for hypogonadism in men with chronic illnesses

Abstract

Mild androgen deficiency and inflammation are common features of many systemic chronic illnesses. Nonspecific complaints such as fatigue, reduced energy, and poor sleep in conjunction with observable sarcopenia and osteopenia, are prominent in many of these chronic disorders, and are reminiscent of symptomatic hypogonadism. Unequivocally androgen-responsive organs include bone, striated muscle, cardiac muscle, vascular smooth muscle, brain and adipose tissues. Androgen therapy, by targeting these tissues, could plausibly ameliorate those features of specific chronic illnesses which arise from dysfunction of these organs. However randomized placebo-controlled trials are still required to establish efficacy. This chapter summarizes and tabulates these pivotal randomized placebo-controlled studies, and makes recommendations regarding potential uses and further research.