Osteopenia and osteoporosis in young men presenting with infertility or sexual dysfunction - clinical experience
Authors:
Darius A. Paduch M. D., Ph.D. 1; Alexander Bolyakov, MSc. 1; J. Kipper R. N. 1; Prof. MUDr. Dalibor Pacík, CSc. 2
Authors‘ workplace:
Department of Urology and
Reproductive Medicine, Weill Cornell
Medical College, New York, NY
And Center for Biomedical Research
Population Council, New York, NY
1; Urologická klinika LF MU, FN Brno
2
Published in:
Urol List 2008; 6(4): 40-53
Overview
Urologists have become the first contact physicians for young men of reproductive age and have unique opportunity to positively affect men's health and quality of life. Growing evidence indicates that significant proportions of men presenting with infertility or sexual dysfunction are hypogonadal. Hypogonadism is one of the main risk factors for osteopenia and osteoporosis which can be found in 6 % of hypogonadal men younger than 50 years. Results of basic science research, animal models with knocked-out estradiol and androgen receptors, and recent description of men with estradiol deficiency, indicate that sex steroids play an important role in normal bone physiology in men. Testosterone replacement therapy is indicated in most men with hypogonadism and low bone mineral density (BMD); however the benefits of testosterone treatment in eugonadal men are doubtful. Selective estradiol and androgen receptor modulators expand our treatment modalities in men in reproductive age when suppression of gonadotropins may interfere with one's reproductive plans. Early detection of hypogonadism and osteoporosis may lower risk of hip and vertebral fractures in some men. Further prospective epidemiological studies are needed to prove cost-effectiveness of detection and the best treatment of osteoporosis in hypogonadal men of reproductive age.
Key words:
osteopenia, osteoporosis, hypogonadism, infertility, sexual dysfunction
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