CoChat
Sign Up
Cited by 148Hormonal and reproductive studiesMenopause: Health Impacts and TreatmentsAdrenal Hormones and Disorders

The Rationale, Efficacy and Safety of Androgen Therapy in Older Men: Future Research and Current Practice Recommendations

Liu, Peter Y., Swerdloff, Ronald S., Veldhuis, Johannes D.·2004·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.2004-0807
Open this paper in CoChat — free account

Abstract

Epidemiological studies indicate that normal male aging is associated with a gradual and variable decline in blood testosterone concentrations and unfavorable changes in muscle, bone, and fat that mimic those of androgen deficiency in young men. These age-related reductions in muscle and bone mass and increased fat mass may be responsible for other age-related changes, including decreased muscle strength and physical function, changes in metabolic function, and increased falls, fractures, and disability. Whether age-related relative androgen deficiency truly causes any of these features requires interventional studies specifically in older men, because aged tissues may not remain androgen sensitive nor is such treatment necessarily safe. A Medline search (years 1966 through January 2004, using search terms random and androgen), supplemented by subsequent reference searches of retrieved articles, identified randomized placebo-controlled studies of androgen therapy. These studies show that androgen replacement in older men increases muscle and reduces fat mass to a small degree, but to date has not improved muscle strength, physical function, or insulin sensitivity, nor does it convincingly improve bone density, although the latter effect is particularly dose responsive. However, idiosyncratic adverse effects, such as disordered sleep and breathing as well as polycythemia, are also dose responsive, suggesting that dose escalation to increase efficacy may create or aggravate undesirable side effects. Furthermore, the clinical safety of androgen therapy for cardiovascular and prostatic disease is uncertain. Under these circumstances, androgen supplementation is not recommended in healthy older men. However, interim recommendations are available to help guide appropriate and curb unnecessary androgen prescription for symptomatic older men with low serum testosterone levels.

Integrity signals

Registry

Crossref · 10.1210/jc.2004-0807

Cites

56 of 56 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The decline in testosterone with age ultimately leads to testosterone levels low enough to trigger consideration of hypogonadism.

    “Therefore the decline in testosterone, irrespective of the underlying reasons for the decline, ultimately leads to testosterone levels that are so low that it triggers consideration of the diagnosis of hypogonadism because suggestive clinical features, which overlap with non-specific features of ageing, are likely to be present already [22].”

    From Sleep, testosterone and cortisol balance, and ageing men (2022) · cites this paper as [22]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Liu, P. Y., Swerdloff, R. S., & Veldhuis, J. D.
Affiliations
  • Mayo Clinic (US)
  • University of California, Los Angeles (US)
Corresponding author
Liu, Peter Y.
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2004-10
Volume
89
Issue
10
Pages
4789-4796
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jc.2004-0807
OpenAlex
W2133685760
Cited by
143
References
56
Citations by year
2025: 1 · 2024: 1 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 6 · 2018: 4 · 2017: 5 · 2016: 2 · 2015: 2 · 2014: 4 · 2013: 4 · 2012: 6
FWCI
3.21
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
testosterone replacement therapy, older men, testosterone, muscle mass, fat mass, bone mineral density, physical function, insulin sensitivity, adverse effects, polycythemia, cardiovascular safety, prostate diseases, treatment guidelines
MeSH terms
Aged, Aging, Androgens, Humans, Male, Middle Aged, Hormone Replacement Therapy

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review