Rodrigues Dos Santos · Annual review of medicine 2021 · narrative review · n=?

Benefits and Risks of Testosterone Treatment in Men with Age-Related Decline in Testosterone.

Cited 67 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review of evidence and clinical guidelines without systematic review methodology

PubMed 33217248 · doi:10.1146/annurev-med-050219-034711 · record verified 2026-08-31

What was done

This narrative review synthesized literature on age-related testosterone decline, the benefits and risks of testosterone replacement therapy in older men, and clinical guidelines from the Endocrine Society.

What was found

No quantitative data or effect sizes are reported in the abstract. Qualitatively, testosterone treatment in older men with low levels improves overall sexual activity, sexual desire, and erectile function; enhances areal and volumetric bone density and estimated bone strength in the hip and spine; corrects unexplained anemia of aging; increases skeletal muscle mass, strength, power, self-reported mobility, and select physical function measures; and modestly improves depressive symptoms. Long-term risks for major adverse cardiovascular events and prostate cancer remain undetermined.

Why it matters

This review outlines the multisystem effects of testosterone replacement in aging men, highlighting that therapy should be restricted to symptomatic individuals with consistently low testosterone rather than applied universally to all older men.

Limits

The abstract describes a narrative review without reporting search strategy, inclusion criteria, or pooled sample size. Specific quantitative effect sizes are omitted, and long-term cardiovascular and oncologic safety outcomes remain unmeasured and uncertain.

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