Physical Activity and Exercise for Men with Late Onset Hypogonadism

Ho Chun Choi; Be Long Cho; Bumjo Oh; Hyun Su Kim

doi:10.5534/kja.2011.29.3.181

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Choi, Cho, Oh, and Kim: Physical Activity and Exercise for Men with Late Onset Hypogonadism

Original Article

Korean J Androl 2011;29(3):181-190.

Published online: 22 December 2011

DOI: https://doi.org/10.5534/kja.2011.29.3.181

Physical Activity and Exercise for Men with Late Onset Hypogonadism

Ho Chun Choi, Be Long Cho, Bumjo Oh, Hyun Su Kim

Department of Family Medicine, Seoul National University Hospital, Seoul, Korea

Received 16 December 201119 December 2011 Accepted 19 December 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Late onset hypogonadism (LOH, also referred to as age-associated testosterone deficiency syndrome, TDS) is a clinical and biochemical syndrome associated with advancing age and characterized by symptoms and a deficiency in serum testosterone levels. It may result in a significantly reduced quality of life and adversely affect the function of multiple organ systems. Although the treatment of LOH is primarily based on hormone replacement, other treatment modalities (medical or non-medical treatment) can also be considered for various accompanying symptoms. The efficacy of exercise in the treatment of LOH has already been evaluated in several studies, and many of them show beneficial effects for some specific symptoms and diseases. This study was designed to evaluate the relationship between exercise and plasma testosterone levels, and the potential beneficial effects of exercise for each specific symptom of LOH, and finally to consider the appropriate exercise treatment for LOH.

Keywords: Male, Hypogonadism, Exercise, Testosterone

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Table 1.

Symptoms and signs suggesting of late onset hypogonadism²

1. Sexual function changes Reduced sexual desire Reduced erectile function (frequency, quality)
2. Somatic changes Reduced muscle bulk and strength Low bone mineral density Increased visceral fat and decreased lean body mass Loss of body hair, changes in skin
3. Psychological symptoms, etc. Poor concentration and memory Reduced mental activity and cognitive function Decreased energy and motivation Feeling sad or blue, depressed mood, dysthymia Sleep disturbance Diminished physical or work performance

Table 2.

Summary of ACSM/AHA physical activity recommendations for older adults⁹²

Endurance exercise
Frequency Moderate-intensity activities: accumulate at least 30 or up to 60 (for greater benefit) minutes/day in bouts of at least 10 min each to total 150∼300 minutes/week Vigorous-intensity activities: accumulate at least 20∼30 minutes/day or more in bouts of at least 10 min each to total 75∼150 minutes/week Combination of moderate and vigorous activities: an equivalent combination of moderate and vigorous activity.
Intensity On a scale of 0 to 10 for level of physical exertion, 5 to 6 for moderate-intensity and 7 to 8 for vigorous intensity.
Type Any modality that does not impose excessive orthopedic stress; walking is the most common type of activity. Aquatic exercise and stationary cycle exercise may be advantageous for those with limited tolerance for weight bearing activity.
Resistance exercise
Frequency: At least 2 days/week Intensity: Between moderate- (5∼6) and vigorous- (7∼8) intensity on a scale of 0 to 10.
Type Progressive weight training program or weight bearing calisthenics (8–10 exercises involving the major muscle groups of 8∼12 repetitions each), stair climbing, and other strengthening activities that use the major muscle groups.
Flexibility exercise
Frequency: At least 2 days/week Intensity: Moderate (5∼6) intensity on a scale of 0 to 10. Type Any activities that maintain or increase flexibility using sustained stretches for each major muscle group and static rather than ballistic movements
Balance exercise ACSM/AHA Guidelines currently recommend balance exercise for individuals who are frequent fallers or for individuals with mobility problems. Because of a lack of adequate research evidence, there are currently no specific recommendations regarding specific frequency, intensity, or type of balance exercises for older adults. However, the ACSM Exercise Prescription Guidelines recommend using activities that include the following: 1) progressively difficult postures that gradually reduce the base of support (e.g. two-legged stand, semitandem stand, tandem stand, one-legged stand), 2) dynamic movements that perturb the center of gravity (e.g., tandem walk, circle turns), 3) stressing postural muscle groups (e.g., heel stands, toe stands), or 4) reducing sensory input (e.g., standing with eyes closed).

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