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Is Testosterone Replacement Therapy in Older Men Effective and Safe?

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Abstract

The number of older adults over 65 years of age is expected to increase to almost 100 million in the US by 2050, more than double the current figure of 46 million. Advanced age is associated with increased frailty among older Americans and often leads to increased disability, hospitalization, institutionalization, and, eventually, mortality. In search of means to improve age-related risks for adverse health outcomes, the question of restoring diminishing sex hormones has gathered much interest and has led to the practice of sex hormone replacement therapies in older men. Recent data suggest that androgen prescription rates in the US for men older than 60 years of age quadrupled from the years 2001 to 2011. While prescription sales of testosterone have increased from $150 million in 2000 to $1.8 billion in 2011, a significant portion of men prescribed testosterone replacement therapy did not meet the laboratory criteria for hypogonadism. While some clinical trials reported an association between testosterone insufficiency in older men and increased risk of death, the exact effects and consequences of testosterone replacement therapy, specifically in older men, remain unclear. This review is aimed at discussing the possible benefits and complications of testosterone replacement therapy in older men over 60 years of age.

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Acknowledgements

The authors acknowledge support from the Oklahoma Center for the Advancement of Science and Technology (HR17-070), the National Institute of General Medical Sciences (NIGMS)-funded Oklahoma Shared Clinical and Translational Resources program (U54GM104938), the Presbyterian Health Foundation, and the NIGMS/National Institutes of Health-funded Cellular and Molecular GeroScience CoBRE (1P20GM125528, sub#5337).

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  1. Donald W. Reynolds Department of Geriatric Medicine, The University of Oklahoma, Health Sciences Center, 1122 NE 13th St., ORB1200, Oklahoma City, OK, 73117, USA

    Andriy Yabluchanskiy & Panayiotis D. Tsitouras

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  1. Andriy Yabluchanskiy
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Correspondence to Panayiotis D. Tsitouras.

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Andriy Yabluchanskiy and Panayiotis D. Tsitouras have no conflicts of interest to disclose.

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Yabluchanskiy, A., Tsitouras, P.D. Is Testosterone Replacement Therapy in Older Men Effective and Safe?. Drugs Aging 36, 981–989 (2019). https://doi.org/10.1007/s40266-019-00716-2

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