アンドロゲン補充療法の実際

Role of Androgen in the Elderly. Clinical androgen replacement therapy for late-onset hypogonadism.

　加齢男性性腺機能低下（late-onset hypogonadism：LOH）症候群に対する治療法の原則は，低下した男性ホルモンの補充である。LOH症候群に対するアンドロゲン補充療法（androgen replacement therapy：ART）の適応に関しては，aging males' symptoms（AMS）スコアによる症状と遊離型テストステロン値に基づき行われる。海外においては，注射薬，パッチ，内服薬などによるARTが幅広く行われているが，わが国におけるARTとしては，２～４週毎のテストステロンエナント酸エステルによる筋肉注射が主に行われている。さらに１日１～２回のOTC（over the counter）薬のテストステロン軟膏も使用可能であり，有効な治療法の一つである。

　Late-onset hypogonadism（LOH）is defined as the condition caused by the decline of testosterone by aging, along with various symptoms, including physical, psychological and sexual disturbance. Thus the principle of treatment for LOH is Androgen replacement therapy（ART），and ART has been applied primarily in order to alleviate the various symptoms in LOH patients. The indication of ART for LOH is determined based on LOH symptoms assessed by aging males' symptoms（AMS）score and serum free testosterone levels. In abroad, several routes are available for the administration of testosterone, such as injection, patch, oral administration, etc. In Japan, intramuscular injection of testosterone enanthate every 2 to 4 weeks is widely indicated for treatment of LOH. It has also reported that ART using testosterone ointment once or twice a day appeared to improve those LOH symptoms. ART is a significant and safe procedure for anti-aging in male.