madman
Super Moderator
Figure 1. Comparative overview of therapeutic approaches for male hypogonadism and metabolic dysfunction. The figure summarizes the key advantages and disadvantages of three main management modalities: GLP-1 receptor agonists (GLP-1 RAs), lifestyle modification (diet and exercise), and testosterone therapy (TTh). GLP-1 RAs provide substantial weight loss and cardiovascular benefit but may lead to muscle loss, mood disturbances, and rebound weight gain upon discontinuation. Diet and exercise remain foundational but are limited by adherence challenges. Testosterone therapy exerts direct androgenic effects, supports muscle mass, and offers multi-systemic benefits, but may increase hematocrit and suppress spermatogenesis.
Introduction
Functional hypogonadism, a manifestation of testosterone deficiency in simultaneously present comorbidities, profoundly impairs quality of life in men with overweight and obesity – yet remains persistently under-recognized in clinical practice.
Findings
Lifestyle modification constitutes first-line therapy, while pharmacological and surgical interventions increasingly complement it. Both promote substantial weight loss and may reverse obesity-related hypogonadism; bariatric surgery, in particular, elicits marked rises in circulating testosterone but entails risks of bone demineralization and uncertain long-term reproductive sequelae. Notwithstanding, testosterone deficiency itself represents a key driver of secondary osteoporosis, insulin resistance, anemia, fatigue, and depression as well as sexual symptoms. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have redefined obesity therapy through profound weight reduction and cardiometabolic benefit, yet concomitant losses of lean mass raise concern over sarcopenia and skeletal fragility.
Conclusion
This focused review article aims to present a comprehensive update on the latest data concerning combining testosterone therapy with contemporary anti-obesity pharmacotherapy as a new standard of care for obese men with functional hypogonadism, uniting metabolic, vascular, sexual, cognitive, and skeletal benefits within a comprehensive strategy to fortify corporeal resilience and enhance quality of life.
Introduction
Functional hypogonadism, a manifestation of testosterone deficiency in simultaneously present comorbidities, profoundly impairs quality of life in men with overweight and obesity – yet remains persistently under-recognized in clinical practice.
Findings
Lifestyle modification constitutes first-line therapy, while pharmacological and surgical interventions increasingly complement it. Both promote substantial weight loss and may reverse obesity-related hypogonadism; bariatric surgery, in particular, elicits marked rises in circulating testosterone but entails risks of bone demineralization and uncertain long-term reproductive sequelae. Notwithstanding, testosterone deficiency itself represents a key driver of secondary osteoporosis, insulin resistance, anemia, fatigue, and depression as well as sexual symptoms. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have redefined obesity therapy through profound weight reduction and cardiometabolic benefit, yet concomitant losses of lean mass raise concern over sarcopenia and skeletal fragility.
Conclusion
This focused review article aims to present a comprehensive update on the latest data concerning combining testosterone therapy with contemporary anti-obesity pharmacotherapy as a new standard of care for obese men with functional hypogonadism, uniting metabolic, vascular, sexual, cognitive, and skeletal benefits within a comprehensive strategy to fortify corporeal resilience and enhance quality of life.
