No, there are fundamental differences between menopause which is a physiologic process affecting all women and Late-Onset Hypogonadism (LOH) affecting only a small proportion of aging men, especially those with comorbid conditions. Neither the medication type nor the treatment populations are comparable.
If testosterone deficiency continues for a long period, osteoporosis and anemia may develop, furthermore reduced muscle mass and strength may lead to severe physical weakness and a significantly impaired general well-being. Negative changes in body composition and metabolism may continue with, so far, unknown consequences for long-term cardiovascular health. Patients will continue to suffer from a loss of libido, erectile dysfunction and severe depression may develop.7
Many systemic diseases (e.g. diabetes mellitus, generalized infections, metabolic syndrome) correlate with low testosterone levels. Therefore, hypogonadism as an early sign can contribute to an early diagnosis of the underlying condition.
Testosterone values in the normal range do not have a negative effect on a healthy heart. Long-term investigations to date actually show positive effects of testosterone on cardiovascular risk factors. In several studies, testosterone has been used successfully in patients with coronary artery disease.
Recent clinical results show favorable effects of testosterone on endothelial function such as reduction of inflammatory cytokines and increase of endothelial progenitor cells.
The abuse of androgenic anabolic steroids by competitive athletes and bodybuilders has given androgens a bad reputation. In rare isolated cases, heart diseases in these men were reported. However, it should not be forgotten that these men take largely supraphysiologic doses, frequently 100 times the recommended dose.
A common question among HCPs and patients is how long testosterone therapy should be provided. Several studies have demonstrated that the beneficial effects of testosterone therapy are not maintained after cessation of treatment.8-14 This applies to improvements in body composition, erectile function, HbA1c, total cholesterol, LDL, HDL, triglycerides, AMS, IPSS, IIEF-EF, residual voiding volume and bladder wall thickness, and quality of life, and likely most – if not all - other testosterone-related outcomes.8-11,13. If testosterone therapy is discontinued, beneficial effects are to appear again when testosterone therapy is resumed.8
As pointed out in the British Society for Sexual Medicine guidelines on Adult Testosterone Deficiency, cessation of testosterone therapy results in reappearance of symptoms and reversal of benefits within 6 months, so testosterone therapy is likely to be required lifelong for persistent symptom resolution and maintenance of health benefits.15