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Der „dicke“ und der „alte“ Patient in der dermatologischen Praxis

Wann muss man an Hypogonadismus denken?

The “obese” and “old” male patient in dermatological practice

When should hypogonadism be considered?

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Zusammenfassung

Hypogonadismus bezeichnet eine endokrine Funktionsstörung der Hoden und führt zu einem Testosteronmangel. Er ist insbesondere bei älteren und adipösen Männern häufig. Symptome mit dem höchsten prädiktiven Wert sind Reduktion sexueller Gedanken, Abnahme der Spontanerektionen und erektile Dysfunktion. Für die Therapie stehen nach Ausschluss von Kontraindikationen (inklusive Kinderwunsch) verschiedene Applikationsformen von Testosteron zur Verfügung. Im Gegensatz zu den weitverbreiteten Annahmen zu Risiken gilt die Behandlung unter entsprechenden Kontrollmaßnahmen als weitgehend sicher.

Abstract

Hypogonadism refers to reduced endocrine function of the testicles and leads to testosterone deficiency. It is often observed in older and obese men. Symptoms with the hightest predictive value are reduced sexual thoughts,decreased spontaneous erections, and erectile dysfunction. After excluding contraindications (e.g., desire for children), various forms of replacement therapy are available. Studies have shown that testosterone therapy is safe if regularly checked.

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Literatur

  1. Corona G et al (2013) Diagnosis and treatment of late-onset hypogonadism: systematic review and meta-analysis of TRT outcomes. Best Pract Res Clin Endocrinol Metab 27(4):557–579

    Article  CAS  PubMed  Google Scholar 

  2. Dean JD et al (2015) The International Society for Sexual Medicine’s Process of Care for the Assessment and Management of Testosterone Deficiency in Adult Men. J Sex Med 12(8):1660–1686 doi:10.1111/jsm.12952

  3. Zitzmann M (2009) The role of the CAG repeat androgen receptor polymorphism in andrology. Front Horm Res 37:52–61

    Article  CAS  PubMed  Google Scholar 

  4. Kaufman JM, Vermeulen A (2005) The decline of androgen levels in elderly men and its clinical and therapeutic implications. Endocr Rev 26:833–876

    Article  CAS  PubMed  Google Scholar 

  5. Rajender S, Singh L, Thangaraj K (2007) Phenotypic heterogeneity of mutations in androgen receptor gene. Asian J Androl 9:147–179

    Article  CAS  PubMed  Google Scholar 

  6. Nieschlag E et al (2009) Andrologie, 3. Aufl. Springer (Verlag), Berlin. (978-3-540-92962-8)

    Book  Google Scholar 

  7. Krause W et al (2011) Andrologie, vierte Auflage. Georg-Thieme-Verlag, Stuttgart. (978-3-13-153224-4)

    Google Scholar 

  8. Welty FK (2015) Targeting inflammation in metabolic syndrome. Transl Res Jul 3. pii: S1931-5244(15)00222-4

  9. Saad F, Aversa A, Isidori AM et al (2012) Testosterone as potential effective therapy in treatment of obesity in men with testosterone deficiency: a review. Curr Diabetes Rev 8:131–143

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  10. Corona G, Rastrelli G, Vignozzi L et al (2011) Testosterone, cardiovascular disease and the metabolic syndrome. Best Pract Res Clin Endocrinol Metab 5:337–353

    Article  Google Scholar 

  11. Schuppe HC, Jung A, Ochsendorf FR, Köhn FM (2014) Psoriasis und Partnerschaft Andrologische Aspekte im Auge haben. Hautnah Dermatol 30(2):105–111

    Article  Google Scholar 

  12. Costanzo PR, Suárez SM et al (2014) Evaluation of the hypothalamic-pituitary-gonadal axis in eugonadal men with type 2 diabetes mellitus. Andrology 2:117–124

    Article  CAS  PubMed  Google Scholar 

  13. Wu FC, Tajar A, Pye SR et al (2008) Hypothalamic-pituitary-testicular axis disruptions in older men are differentially linked to age and modifiable risk factors: the European Male Aging Study. J Clin Endocrinol Metab 93:2737–2745

    Article  CAS  PubMed  Google Scholar 

  14. Dohle GR et al (2013) Leitlinie Männlicher Hypogonadismus J. Reproduktionsmed. Endokrinol 10(5–6):279–292

    Google Scholar 

  15. Basaria S (2014) Male hypogonadism. Lancet 383(9924):1250–1263

    Article  CAS  PubMed  Google Scholar 

  16. Kalyani RR, Dobs AS (2007) Androgen deficiency, diabetes, and the metabolic syndrome in men. Curr Opin Endocrinol Diab Obes 14:226–234

    Article  CAS  Google Scholar 

  17. Boehncke S, Salgo R, Garbaraviciene J, Beschmann H, Ackermann H, Boehncke WH, Ochsendorf FR (2011) Changes in the sex hormone profile of male patients with moderate-to-severe plaque-type psoriasis under systemic therapy: results of a prospective longitudinal pilot study. Arch Dermatol Res 303(6):417–424

    Article  CAS  PubMed  Google Scholar 

  18. Wu FC et al (2010) Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med 363:123–135

    Article  CAS  PubMed  Google Scholar 

  19. Zitzmann M et al (2006) Association of specific symptoms and metabolic risks with serum testosterone in older men. J Clin Endocrinol Metabol 91:4335–4343

  20. Vermeulen A (2005) Hormonal cut-offs of partial androgen deficiency: a survey of androgen assays. J Endocrinol Invest 28(3 Suppl):28–31

    CAS  PubMed  Google Scholar 

  21. Rosner W et al (2007) Utility, limitations, and pitfalls in measuring testosterone: an endocrine society position statement. J Clin Endocrinol Metab 92:405–413

    Article  CAS  PubMed  Google Scholar 

  22. Milenković L, D’Angelo G, Kelly PA, Weiner RI (1994) Inhibition of gonadotropin hormone-releasing hormone release by prolactin from GT1 neuronal cell lines through prolactin receptors. Proc Natl Acad Sci USA 91:1244–1247

    Article  PubMed Central  PubMed  Google Scholar 

  23. Carter JN, Tyson JE, Tolis G, Van Vliet S, Faiman C, Friesen HG (1978) Prolactin-screening tumors and hypogonadism in 22 men. N Engl J Med 299:847–852

    Article  CAS  PubMed  Google Scholar 

  24. Basaria S, Coviello AD et al (2010) Adverse events associated with testosterone administration. N Engl J Med 363:109–122

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  25. Srinivas-Shankar U, Roberts SA et al (2010) Effects of testosterone on muscle strength, physical function, body composition, and quality of life in intermediate-frail and frail elderly men: a randomized, double-blind, placebo-controlled study. J Clin Endocrinol Metab 95:639

    Article  CAS  PubMed  Google Scholar 

  26. Saad F, Haider A, Doros G, Traish A (2013) Long-term treatment of hypogonadal men with testosterone produces substantial and sustained weight loss. Obes (Silver Spring) 21:1975–1981

    Article  CAS  Google Scholar 

  27. Muraleedharan V, Marsh H, Kapoor D, Channer KS, Jones TH (2013) Testosterone deficiency is associated with increased risk of mortality and testosterone replacement improves survival in men with type 2 diabetes. Eur J Endocrinol 169:725–733

    Article  CAS  PubMed  Google Scholar 

  28. Camacho EM, Huhtaniemi IT, O’Neill TW et al (2013) Age associated changes in hypothalamic pituitary testicular function in middle aged and older men are modified by weight change and lifestyle factors: longitudinal results from the European Male Ageing Study. Eur J Endocrinol 168:445–455

    Article  CAS  PubMed  Google Scholar 

  29. Corona G et al (2015) Obesity and late-onset hypogonadism. Mol Cell Endocrinol Jul 2. pii: S0303-7207(15)00338-X

  30. Vignozzi L, Filippi S et al (2014b) Metformin in vitro and in vivo increases adenosine signaling in rabbit corpora cavernosa. J Sex Med 11:1694–1708

  31. Schreiber G et al (2008) The aging male-diagnosis and therapy of late-onset hypogonadism. J Dtsch Dermatol Ges 6(4):273–279

    Article  PubMed  Google Scholar 

  32. Medras M, Filus A, Jozkow P et al (2006) Breast cancer and long term hormonal treatment of male hypogonadism. Breast Cancer Res Treat 96:263–265

    Article  CAS  PubMed  Google Scholar 

  33. Seftel AD et al (2015) Critical update of the 2010 endocrine society clinical practice guidelines for male hypogonadism: a systematic analysis. Mayo Clin Proc 90(8):1104–1115

    Article  PubMed  Google Scholar 

  34. Klap J et al (2015) The relationship between total testosterone levels and prostate cancer: a review of the continuing controversy. J Urol 93(2):403–413

    Article  Google Scholar 

  35. Morgentaler A, Morales A (2010) Should hypogonadal men with prostate cancer receive testosterone? J Urol 184:1257–1260

    Article  PubMed  Google Scholar 

  36. Kaufman JM, Graydon RJ (2004) Androgen replacement after curative radical prostatectomy for prostate cancer in hypogonadal men. J Urol 172:920–922

    Article  CAS  PubMed  Google Scholar 

  37. Corona G, Maseroli E et al (2014) Cardiovascular risk associated with testosterone-boosting medications: a systematic review and meta-analysis. Expert Opin Drug Saf 13:1327–1351

    Article  CAS  PubMed  Google Scholar 

  38. Jones SD Jr (2015) Thomas Dukovac Erythrocytosis Secondary to TRT. Sex Med Rev 3:101–112

    Article  Google Scholar 

  39. Hanafy HM (2007) Testosterone therapy and obstructive sleep apnea: is there a real connection? J Sex Med 4:1241–1246

    Article  CAS  PubMed  Google Scholar 

  40. Hoyos CM, Yee BJ et al (2012) Body compositional and cardiometabolic effects of testosterone therapy in obese men with severe obstructive sleep apnoea: a randomised placebo-controlled trial. Eur J Endocrinol 167(4):531–541

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Klinik und Poliklinik für Dermatologie u. Venerologie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland

    D. Varwig-Janßen

  2. Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Frankfurt, Frankfurt am Main, Deutschland

    F. Ochsendorf

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  1. D. Varwig-Janßen
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Correspondence to D. Varwig-Janßen.

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D. Varwig-Janßen und F. Ochsendorf geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Varwig-Janßen, D., Ochsendorf, F. Der „dicke“ und der „alte“ Patient in der dermatologischen Praxis. Hautarzt 66, 898–906 (2015). https://doi.org/10.1007/s00105-015-3716-8

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