Bedeutung, Indikationen, Diagnostik, Therapie - Hormontherapie beim älteren Mann

Zusammenfassung

Gerade vor dem Hintergrund der demografischen Situation einer immer älter werdenden Gesellschaft ist es von großem Interesse, die Auswirkungen eines Testosteronmangels bei älteren Männern und dessen Therapie intensiv zu beforschen. Denn mit der Therapie lässt sich dem Schwund der Muskel- und Knochenmasse, der Anämie, der nachlassenden Potenz wie auch der zunehmenden Adipositas erfolgreich entgegen wirken. Dies wiederum trägt dazu bei, die Selbstständigkeit der Betroffenen zu erhalten und eine potenzielle Betreuungs- und Pflegebedürftigkeit zu verhindern. Diskutiert werden auch positive Auswirkungen auf das Herz-Kreislaufsystem. Das Risiko bezüglich der Indikation oder Progression eines Prostatakarzinoms scheint nach aktueller Studienlage eher gering zu sein. Dennoch ist die Testosteronsubstitution beim Late-onset-Hypogonadismus keinesfalls als Standard und abgesichert anzusehen, denn die Erfahrungen mit der Hormontherapie beruhen überwiegend auf vergleichsweise kleinen Studien mit kurzen Beobachtungsintervallen. Daher ist es von besonderer Bedeutung, Nutzen und Risiko einer Testosteronsubstitution genau abzuwägen und Kontraindikationen zu beachten.

Summary

Against the background of the demographic situation in a progressively ageing society it is of particular interest to closely investigate the effects of testosterone deficiency in the elderly man, and its treatment. For this form of therapy can successfully counteract the loss of muscle mass and bone substance, anaemia, declining virility and increasing obesity. This in turn helps to preserve the independence of this group and prevent a potential need for nursing care. A possible positive impact on the cardiovascular system is also under discussion. Current data indicate that the risk concerning the indication or progression of prostate carcinoma is low. Nevertheless, testosterone replacement in late-onset hypogonadism must not be considered standard and confirmed treatment, since most experience with hormone therapy has been gained in relatively small studies involving short periods of observation. It is thus of particular importance to weigh up the benefits and risks of testosterone substitution and to take account of contraindications.

Key Words

late-onset hypogonadism - testosterone substitution - prostate gland

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