Hypogonadism: cardiometabolism and gonadal function in men

Hypogonadism is a relatively rare condition in men, which increases in frequency as men age, but also as they become less active and gain weight. In the past 20 years, developing knowledge on the relationship between hypogonadism and cardiovascular and cerebrovascular health and on aspects of metabolic health has become clearer. The relationship between hypogonadism and specific endocrine abnormalities of spermatogenesis is much longer established. Long- and short-term testosterone replacement therapies have well-recognised effects on cardiovascular and cerebrovascular health and on aspects of metabolic health. This leads to a sense of safety when it comes to considering these options as ways of managing the recognised symptoms of hypogonadism and the hidden adverse findings. That confidence has yet to be proven by long-term randomised controlled studies. The use of exogenous gonadotrophins to raise endogenous testosterone levels is a cost-efficient method of achieving spermatogenesis but is not suitable for long-term testosterone maintenance therapy.

性腺功能减退症在男性中是一种相对罕见的疾病，其发病率随着男性年龄的增长而增加，也随着他们活动量减少和体重增加而上升。在过去20年中，关于性腺功能减退症与心脑血管健康以及代谢健康各方面之间关系的认识变得更加清晰。性腺功能减退症与精子发生的特定内分泌异常之间的关系确立的时间要长得多。长期和短期的睾酮替代疗法对心脑血管健康以及代谢健康各方面具有公认的影响。当考虑将这些方法作为治疗性腺功能减退症的公认症状以及潜在不良发现的手段时，这会给人一种安全感。然而，这种信心尚未得到长期随机对照研究的证实。使用外源性促性腺激素来提高内源性睾酮水平是一种实现精子发生的具有成本效益的方法，但不适合用于长期的睾酮维持治疗。