睾丸素-老年人的“燃料”?]

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-01-01 Epub Date: 2024-12-21 DOI:10.1007/s00108-024-01824-x
Michael Zitzmann
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引用次数: 0

摘要

睾丸素是一种天然激素,无论年龄大小,它都是维持男性身心健康的重要因素。男性性腺功能减退症是一种睾酮缺乏的内分泌状况,有可能导致多种身体不适和心理问题。这种情况可以是原发性的(由于睾丸损伤),继发性的(由于下丘脑或垂体的疾病)或功能性的(由于合并症,如炎症性疾病,肥胖,2型糖尿病)。睾酮缺乏会导致性问题,促进代谢失衡,损害身体机能(肌肉减少,脂肪增加)。此外,在性腺功能减退的情况下,抑郁症,骨质疏松症和/或贫血往往发展。有生育愿望、前列腺或乳腺病变不清或红细胞压积值升高的患者不应开始睾酮替代疗法。诊断以及治疗和治疗监测应遵循国际准则,然后可以预期上述投诉的明显改善。尤其是功能性性腺功能减退症,这是大多数但不是唯一诊断在老年男性,总是需要治疗潜在的合并症之前,开始使用睾酮。
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[Testosterone-"Fuel" for old men?]

Testosterone is a natural hormone which is an essential factor to maintain the physical and emotional well-being in men, regardless of age. Male hypogonadism is an endocrinal condition of testosterone deficiency with the potential to cause multiple physical complaints and psychosocial problems. The condition can be of primary (due to testicular injury), secondary (due to diseases of the hypothalamus or pituitary gland) or functional nature (due to comorbidities, such as inflammatory diseases, obesity, type 2 diabetes mellitus). Testosterone deficiency causes problems of a sexual nature, promotes metabolic disequilibrium and can impair physical abilities (reduction in muscle mass, increase in fat mass). In addition, in the condition of hypogonadism depression, osteoporosis and/or anemia often develop. A testosterone replacement therapy should not be initiated in cases of a desire to have children, unclear processes of the prostate glands or mammary glands or an elevated hematocrit value. The diagnosis as well as treatment and monitoring of the treatment should follow the international guidelines and then a clear improvement in the abovenamed complaints can be expected. Particularly functional hypogonadism, which is mostly but not exclusively diagnosed in older men, always requires treatment of the underlying comorbidity prior to starting testosterone administration.

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