Salute maschile e livelli di testosterone: cosa dice la scienza?

Nell’uomo i livelli di testosterone diminuiscono con l’avanzare degli anni?

La rivista Maturitas ad aprile 2026 chiarisceche i livelli di testosterone dipendono principalmente dallo stato di salute piuttosto che dall'età dell’uomo (1). 

L’abbassamento dei livelli sierici di testosterone risulta infatti particolarmente frequente in presenza di sovrappeso / obesità, sindrome metabolica e diabete di tipo 2, indipendentemente dall’età anagrafica (1).

Gli uomini obesi, ad esempio, hanno livelli di testosterone inferiori di circa i 30% rispetto ai normopeso (1-5, 19, 20).

E’ quanto emerge da un’ampia ricerca svolta su oltre 200.000 uomini (età 40-70 anni), e da altri studi che hanno individuato il collegamento bidirezionale tra il declino delle concentrazioni sieriche di testosterone e le malattie metaboliche, ed altre condizioni causa d’infiammazione cronica e di precoce invecchiamento biologico(1-5).

Quali possono essere i segnali d’allarme?

In primo luogo la presenza di sintomi clinicamente rilevanti, es.: calo della libido, disfunzione erettile, depressione, declino della cognitività, stanchezza persistente, perdita di massa muscolare ecc. (1, 2);

In questi casi è necessario sottoporsi ad un’accurata valutazione medica per indagare le possibili cause, e se esistono condizioni cliniche riconducibile al cosiddetto ipogonadismo funzionale, caratterizzato da:

•   bassi livelli sierici di testosterone, inferiori a 12 nmol/l;

•   assenza di patologie dei testicoli (ipogonadismo primario) o dell’asse ipotalamo-ipofisi-gonadi (ipogonadismo secondario).

Esistono fattori aggravanti indipendenti dall’età?

Oltre alle citate disfunzioni metaboliche (1-5, 19, 20, 47-52), i disturbi ormonali e della fertilità risultano associati a vari fattori di rischio, es.:

•   esposizione ad inquinanti come bisfenoli, ftalati, pesticidi, erbicidi, diossina, metalli pesanti, microplastiche, sostanze poli- e perfluoroalchiliche (PFAS), ed il particolato PM2,5 (2, 4, 5, 21);

•   sedentarietà, fumo ed alcol, squilibri qualitativi e quantitativi dell’alimentazione (2, 4, 5, 22, 23, 25, 31);

•   eccessiva e prolungata esposizione al calore (5, 20);

•   stress psicofisico (2, 19);

•   ridotta qualità e durata del sonno, sindrome delle apnee ostruttive notturne (20, 24);

•   assunzione di steroidi anabolizzanti (19);

•   insufficiente assunzione giornaliera di folati / acido folico (20, 26, 27), vitamina A (20), vitamina B6 (28), vitamina B12, (28, 29, 30), vitamina D (25, 31-34);

•   attività fisico sportiva di elevata intensità e volume. Gli atleti endurance (es.: ciclisti, maratoneti) risultano ad alto rischiodi disturbi della riproduzione e declino del testosterone (5, 35, 36). Questo deriverebbe anche dal possibile insufficiente apporto alimentare qualitativo e quantitativo (5);

•   malattie infiammatorie ed autoimmuni  (37, 38, 39);

•   infezioni dell’apparato urogenitale, es.: prostatiti, epididimiti ecc. (4). Esistono inoltre strette e reciproche interazioni tra disturbi della prostata, livelli di androgeni e perdita di massa muscolare (40, 41); 

•   steatosi epatica associata a disfunzioni metaboliche (42-46).

Quali possono essere le conseguenze degli insufficienti livelli di testosterone?

Il testosterone svolge importanti funzioni per controllare il metabolismo osseo, glucidico, proteico ecc., oltre a svolgere azioni antinfiammatorie ed immunoregolatrici (1-5,  9, 40, 53-59).

Come anticipato il calo della libido, la disfunzione erettile, la stanchezza cronica, la depressione sono tipiche conseguenze dell’ipogonadismo (1, 3, 4, 5, 9, 40, 53-59). 

Inoltre, l’abbassamento dei livelli di testosterone aumenta il rischio di varie malattie, come quelle cardiovascolari, metaboliche e neurologiche; che, a loro volta, possono aggravare il declino ormonale maschile, attraverso l’aumento dello stress ossidativo e dell’infiammazione cronica (1-5, 9, 40, 53-59).

E’ possibile prevenire il declino del testosterone?

Mantenere un’elevata capacità antiossidante dell’organismo offre notevoli vantaggi per prevenire ed attenuare il precoce invecchiamento delle cellule specializzate per la biosintesi del testosterone e la spermatogenesi, oltre a ridurre il rischio di malattie croniche associate all’ipogonadismo ed all’infertilità (2, 5, 20, 31).

Infatti, l’adeguato apporto quantitativo e qualitativo di macro- e micronutrienti e l’opportuna riduzione dei fattori di rischio modificabili (es.: sovrappeso / obesità, fumo, alcol), risultano efficaci fino dalla giovane età per preservare nel tempo i livelli fisiologici di testosterone, le capacità riproduttive, ed i migliori standard di performance psicofisica e di vitalità (2, 5, 20, 31, 62, 63, 64).

Significativi risultati clinici sono stati ottenuti con l’integrazione mirata di vitamine, antiossidanti e antinfiammatori naturali, che non sempre l’alimentazione quotidiana riesce a fornire in quantità sufficienti (40, 41, 62, 63, 64, 76), ad esempio:

- vitamine del gruppo B, in particolare B6, folati / acido folico, B12 (28, 31, 65-69);

- coenzima Q10, anche in associazione a vitamina C, E, L-carnitina, zinco (2, 4, 25, 31, 71-95, 99, 100-112);

- polifenoli come curcumina e resveratrolo (2, 31, 77-84, 96).   

Per preservare l’equilibrio ormonale maschile risulta inoltre importante mantenere adeguati livelli di vitamina D, magnesio, calcio, selenio, ed un regime alimentare bilanciato di stile mediterraneo, comprendente proteine di alta qualità, ed acidi grassi omega 3 (31).    

Quali sono gli attuali orientamenti clinici per la terapia con testosterone?

Le più recenti linee guida, es.:European Association of Urology (113) e International Consultation on Sexual Medicine (114), forniscono precisi orientamenti clinici per la corretta e sicura gestione dell’ipogonadismo (1, 2, 113-116).

Secondo queste linee guida, nel caso dell’ipogonadismo funzionale con presenza dei sintomi, è in primo luogo necessario risolvere o migliorare i problemi clinici concomitanti, es.: ridurre il grasso corporeo, normalizzare i parametri metabolici (1, 2, 113-116). E’ inoltre opportuno a considerare la terapia con testosterone in base agli attuali criteri clinici, ed in assenza di controindicazioni (1, 2, 113-116). 

Tra i punti chiave di maggiore rilievo definiti dalle linee guida, si distinguono (1, 2, 113-116):

•   La terapia sostitutiva con testosterone è indicata per i pazienti sintomatici con livelli di testosterone inferiori a 12 nmol/l, dopo un’accurata verifica delle possibili controindicazioni, come malattie oncologiche, cardiovascolari ecc.

•   Il quadro clinico considerato per attivare la terapia comprende: calo della libido, disfunzione erettile, declino delle funzioni cognitive, disturbi del sonno, depressione, stanchezza, perdita di massa muscolare, aumento del grasso viscerale, osteopenia ecc.

•   Il trattamento appropriato con testosterone (iniettivo, gel ecc.) permette di migliorare la qualità di vita e la funzione sessuale dei pazienti. Mentre per la risoluzione o il miglioramento di altre condizioni cliniche, es.: disturbi depressivi, salute ossea, disturbi cognitivi e del sonno, le linee guida suggeriscono trattamenti specifici, perché la sola terapia con testosterone non può essere risolutiva. 

In sintesi, gli studi clinici cosa suggeriscono agli uomini per proteggere la biosintesi del testosterone e la salute riproduttiva fino dalla giovane età? 

•   Assumere giornalmenteun’adeguato e bilanciato consumo di macro- e micro-elementi attraverso i cibi dell’alimentazione mediterranea;

•   Ridurre i fattori di rischio causa d’infiammazione (es.: sovrappeso / obesità, fumo, alcol, stress psicofisico, inquinanti).

•   Prevenire e curare correttamente le malattie metaboliche(sindrome metabolica, diabete tipo 2), che facilitano in modo bidirezionale il declino del testosterone e le disfunzioni riproduttive.

•   Considerare l’uso di determinati integratori alimentari, in caso di insufficiente apporto giornaliero di micronutrienti, o di aumentato fabbisogno dovuto all’elevata esposizione ai fattori di rischio. Ad esempio, i nutraceutici della ricerca Mitochon srl offrono un significativo supporto anche per preservare e conservare nel tempo la salute maschile. 

Sottoporsi ad accurate visite medichequando si manifestano i citati sintomi, per valutare con il medico curante la possibile gestione farmacologica dell’ipogonadismo clinicamente diagnosticato. Attualmente esistono precisi parametri e criteri, definiti dalle linee guida, per l’uso appropriato e sicuro della terapia con testosterone, in associazione al controllo ponderale, ed altri interventi contro i fattori di rischio interni ed esterni all’organismo.

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61. Khin C, Kyaw O, Thangaraj S, Akinsolu O, Elfiky A, D'Sa P, Chan G, Rogers B. Hip Fractures and Hypogonadism in Young Males: A Missed Opportunity for Secondary Prevention? Cureus. 2025 Aug 18;17(8):e90445. doi: 10.7759/cureus.90445. 

62. Mini Review Peakspan una nuova dimensione dell’invecchiamento 2026 https://www.mitochon.it/peakspan-una-nuova-dimensionedellinvecchiamento/?v=0d149b90e739

63. Mini-Review Stress ambientali e ruolo dei mitocondri 2026 https://www.mitochon.it/stress-ambientali-e-integrita-mitocondriale-nellantiaging-cutaneo/?v=0d149b90e739

64. Mini-Review umore - energia - vitalità ruolo antiossidanti e vitamine 2025 https://www.mitochon.it/antiossidanti-e-vitamine-quali-effetti-su-umore-energia-e-vitalita/?v=0d149b90e739

65. Awashra A, AbuBaha M, Istetieh K, Sandouka D, Aldwaik S, AbuBaha B, Saife S, Emara A, Zahran A, Elgendy MS, Shubietah A, Baniowda MA. B vitamins and cardiovascular health: mechanisms, clinical evidence, and precision prevention strategies. Nutr Metab (Lond). 2026 May 1. doi: 10.1186/s12986-026-01125-0.

66. Suzuki M, Kim HY, Reed MC, Nijhout HF, Cruikshank A, Abdelmalek M, Diehl AM, Yen PM, Singh BK, Tripathi M, Suzuki A. Elevated Homocysteine is Associated With Liver Fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease in a Sex- and Menopause-Specific Manner. Gastro Hep Adv. 2025 Sep 10;5(1):100800. doi: 10.1016/j.gastha.2025.100800.

67. Papazachariou A, Papakitsou I, Malikides V, Filippatos TD. Vitamin B12 deficiency among older adults and its associations with geriatric syndromes. Curr Opin Clin Nutr Metab Care. 2026 Jan 1;29(1):21-27. doi: 10.1097/MCO.0000000000001171.

68. Al Qassab M, Bou Ghanem A, Hussayni Y, Kadbey R, Ratel Y, Yehya S, Zahr M, Ghadieh HE, Abi Khattar Z, Azar S, Kanaan A, Harb F. One-carbon metabolism and cardiovascular disease: Molecular mechanisms, genetic influences, and epigenetic regulation. Biochem Biophys Rep. 2026 Mar 17;46:102544. doi: 10.1016/j.bbrep.2026.102544. 

69. Boga A, Noyan B, Silahlı NY, Sekizkardes H, Karaagac AT, Sayman EN, Calıskan SG, Culha Hosceylan I, Guven S. Serum Homocysteine, Insulin Resistance, and Metabolic Risk Factors in Children and Adolescents with Obesity: A Retrospective Cross-Sectional Study. J Clin Med. 2026 Mar 14;15(6):2216. doi: 10.3390/jcm15062216. 

70. Akhigbe TM, Fidelis FB, Adekunle AO, Ashonibare VJ, Akorede BA, Shuaibu MS, Hassan SA, Adegbola CA, Ashonibare PJ, Oladapo OM, Adeogun AE, Bamidele SG, Oyedokun PA, Mukolokota M, Kukoyi OS, Oladipo AA, Adelowo OE, Akangbe MD, Hughes JR, Ricken AM, Culty M, Avellar MCW, Akhigbe RE. Does coenzyme Q10 improve semen quality and circulating testosterone level? a systematic review and meta-analysis of randomized controlled trials. Front Pharmacol. 2025 Jan 3;15:1497930. doi: 10.3389/fphar.2024.1497930.

71. Akhigbe RE, Oyedokun PA, Adeogun AE, Ogunleye OO, Adegbola CA, Akhigbe TM. The aging male: impact of aging on male reproduction. Biogerontology. 2025 Oct 31;26(6):198. doi: 10.1007/s10522-025-10343-7.

72. Ramgir-Naidu S, Abubakar YA, Soni M. Nutritional modulation of male fertility: a molecular-focused scoping review. J Health Popul Nutr. 2026 Jun 17. doi: 10.1186/s41043-026-01374-y.  

73. Higazy A, Mohammed W, Esmat M, Samir M. Evaluation of monotherapy of Coenzyme Q10, L-carnitine or combined therapy on semen parameters in idiopathic male infertility: A placebo-controlled double blind randomized clinical trial. Arab J Urol. 2025 May 24;24(1):68-74. doi: 10.1080/20905998.2025.2509424.

74. Ma L, Sun Y. Comparison of L-Carnitine vs. Coq10 and Vitamin E for idiopathic male infertility: a randomized controlled trial. Eur Rev Med Pharmacol Sci. 2022 Jul;26(13):4698-4704. doi: 10.26355/eurrev_202207_29194.

75. Rochdi C, Ouadrhiri M, Allai L, Bellajdel I, Mamri S, Taheri H, Saadi H, Mimouni A, Choukri M. Beneficial effects of oral antioxidant supplementation on semen quality parameters, reproductive hormones, and sperm DNA integrity in men with idiopathic oligoasthenoteratozoospermia. Clin Exp Reprod Med. 2024 Jun;51(2):135-141. doi: 10.5653/cerm.2023.06555.

76. Mini-Review studio pilota Mitofast 2024 https://www.mitochon.it/mitofast-nuovi-ed-importanti-risultati-da-uno-studio-clinico-preliminare/

77. Mini-Review Resveratrolo - Età biologica / Coenzima Q10 disfunzione mitocondriale 2025 https://www.mitochon.it/resveratrolo-coenzima-q10-eta-biologica-mitocondri-cosa-ce-di-nuovo/?v=0d149b90e739

78. Mini-Review Coenzima Q10 - Resvreatrolo aterosclerosi - performance muscolare 2026 https://www.mitochon.it/coenzima-q10-novita-di-fine-2025-ed-inizio-2026/?v=0d149b90e739

79. Mini-Review Antiaging cognitivo 2025 https://www.mitochon.it/antiaging-cognitivo/?v=0d149b90e739

80. Mini-Review Antiaging cardiovascolare 2025 https://www.mitochon.it/antiaging-cardiovascolare/?v=0d149b90e739

81. Mini-Review Antiaging muscolare 2025 https://www.mitochon.it/antiaging-muscolare/?v=0d149b90e739

82. Mini-Review Osteoporosi - Resveratrolo 2025 https://www.mitochon.it/osteoporosi-nel-post-menopausa-attualita-sul-ruolo-del-resveratrolo-altri-antiossidanti-e-vitamine/?v=0d149b90e739

83. Mini-Review Sovrappenso / Obesità - Resveratrolo - Antiossidanti 2025 https://www.mitochon.it/sovrappeso-obesita-quale-contributo-dal-resveratrolo-ed-altri-antiossidanti/?v=0d149b90e739

84. Martin LJ, Touaibia M. Prevention of Male Late-Onset Hypogonadism by Natural Polyphenolic Antioxidants. Nutrients. 2024 Jun 9;16(12):1815. doi: 10.3390/nu16121815.

85.Wu H, Jian MT, Ning G, Li BN, Peng AJ, Wang HY, Tang X, Zhou X. Male testosterone synthesis disorders: oxidative stress pathways, regulatory mechanisms, potential of antioxidant therapy, and botanical medicine prospects. Asian J Androl. 2026 Apr 3. doi: 10.4103/aja2025105. 

86. Jaganjac M, Orie NN. Modulation of Redox Balance by Phytochemicals: Implications for Cardiovascular Health. Nutrients. 2026; 18(8):1204. https://doi.org/10.3390/nu18081204

87. Kumble J, Frishman WH. Coenzyme Q10 in Cardiovascular Medicine: Mechanisms, Clinical Evidence, and Future Integration in Heart Failure and Statin Myopathy. Cardiol Rev. 2026 Jan 12. doi: 10.1097/CRD.0000000000001135. 

88. Wu X, Fang T. Advances in cardiovascular supplementation: mechanisms, efficacy, and clinical perspectives. Front Mol Biosci. 2026 Jan 26;12:1699492. doi: 10.3389/fmolb.2025.1699492.

89. Nawathe V, Verma S, Pal A, Pawar D, Sharma A. A to Z of Health: An Evidence-Based Narrative Review of Multivitamin-Multimineral and Nutraceutical Supplementation. Cureus. 2026 Apr 30;18(4):e108032. doi: 10.7759/cureus.108032.

90. Leaovitavat R, Palakornkitti P, Thetsana P, Teng-Umnuay P. Effects of Ubiquinol on Oxidized Low-Density Lipoprotein in Prediabetic Patients: A Randomized, Double-Blinded, Placebo-Controlled Study. Biomed Res Int. 2026 Mar 8;2026:8739655. doi: 10.1155/bmri/8739655.

91. Zhang Z, Liu Z, Geng Y, Huang Y, Hu R, Li F, Song Y, Zhang M. Effects of Coenzyme Q10 on Lipid, Glycemic, and Inflammatory Markers in Metabolic Disorders: A Systematic Review and Meta-Analysis. J Diabetes Res. 2026;2026(1):e5587445. doi: 10.1155/jdr/5587445.

92. Collares LDN, Peres Messenburger G, Nuñez FF, Pieniz S. The effects of coenzyme Q10 supplementation on glycemic control in diabetic and non-diabetic individuals: a systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2026 Feb 2:1-23. doi: 10.1080/10408398.2026.2624477. 

93. Musazadeh V, Falahatzadeh M, Mahmoudinezhad M, Shahhooseini E, Jamali M, Pam P, Shidfar F. Effects of Coenzyme Q10 Supplementation on Glycemic Control Biomarkers: An Umbrella Review of Meta-Analyses of Randomised Controlled Trials. Endocrinol Diabetes Metab. 2026 Mar;9(2):e70182. doi: 10.1002/edm2.70182.

94. Castillo-Moral Á, Toda-Ferran C, Bulló M, Teichenné J, Escoté X. Nutraceuticals and the Microbiota-Gut-Brain Axis: A Pathway for Preventing Cognitive Decline. Nutr Rev. 2026 Mar 24:nuag017. doi: 10.1093/nutrit/nuag017. 

95. Nankivell MC, Rosenfeldt F, Reddan JM, de Haan JB, Zhang Ping C, Campbell-Brown B, Pipingas A, Pase MP, Ou R, Cooke MB, et al. Effect of Ubiquinol on Cognitive Function, Blood Pressure, Arterial Stiffness, and Biomarkers of Oxidative Stress and Inflammation in the Elderly: A Randomized Trial. Antioxidants. 2026; 15(7):806. https://doi.org/10.3390/antiox15070806

96. Jach ME, Sajnaga E, Ozimek E, Serefko A, Locatelli M. Probiotic–Plant Bioactive Synergy in Gut Health: Mechanisms, Antimicrobial Activity, and Translational Challenges. Nutrients. 2026; 18(13):2112. https://doi.org/10.3390/nu18132112

97. Mini-Review Glutathione e N-acetilcisteina nelle strategie antiaging 2026 https://www.mitochon.it/glutatione-e-n-acetilcisteina-nelle-strategie-antiaging/?v=0d149b90e739

98. Ma X, Yang Y, Liu S, Cui Y, Wu J. Meta-analysis of the efficacy and safety of L-carnitine and N-acetylcysteine monotherapy for male idiopathic infertility. Rev Int Androl. 2025 Mar;23(1):1-12. doi: 10.22514/j.androl.2025.004. 

99. Nian, M., Xiang, J., Xu, P. et al. Can Nutrition Intake Counteract Harmful Impact of Endocrine Disruptors on Male Sex Hormones? Insights from NHANES 2013–2016. Bull Environ Contam Toxicol 115, 57 (2025). https://doi.org/10.1007/s00128-025-04108-8

100. Pavić Vulinović M, Micek V, Breljak D, Vrhovac Madunić I, Madunić J, Ljubojević M. Overview of the Zinc Functional Interactome Through Health Hallmarks and Medical Conditions. Nutrients. 2026; 18(2):336. https://doi.org/10.3390/nu18020336

101. Zhou Y, Zhou J, Li Z, Wang J, Li H, Yin X, Gao J, Wu Y, Li J, Sun YX, Li Y, Wang W, Eser PO, Assimes TL, He J, Chen G. Bidirectional associations of zinc supplement intake with biological ageing interacted by metabolic equivalent of task: A large-scale population-based Biobank study. Clin Nutr. 2025 Jul;50:1-9. doi: 10.1016/j.clnu.2025.04.029.
102. Baarz BR, Rink L. Rebalancing the unbalanced aged immune system - A special focus on zinc. Ageing Res Rev. 2022 Feb;74:101541. doi: 10.1016/j.arr.2021.101541.
103. Wang Y, Zhu W, Zhang T, Liu Q, Zou M, Xie Y, Wang M, Wang TS, Pang Y, Jing T, Zhang R. Associations between serum trace elements and biological age acceleration in the Chinese elderly: A community-based study investigating the mediating role of inflammatory markers and the moderating effect of physical activity. J Hazard Mater. 2025 Jul 15;492:138273. doi: 10.1016/j.jhazmat. 2025.138273.

104. Li Y, Peng D, Yu Z, Deng J, Zhao L, Cao R. Association between methyl donor nutrients' dietary intake with phenotypic aging among US adults: a cross-sectional study from NHANES 2005-2018. Sci Rep. 2025 Apr 12;15(1):12591. doi: 10.1038/s41598-025-96668-2.

105. Nogueira-de-Almeida CA, Gutiérrez CAC, Ramos LR, Katz M, Gonzalez MM, Angel Badillo B, Gómez Santa María OA, Reyes Torres CA, O'Neill S, Reyes MG, Mustapic L. Role of Micronutrient Supplementation in Promoting Cognitive Healthy Aging in Latin America: Evidence-Based Consensus Statement. Nutrients. 2025 Aug 2;17(15):2545. doi: 10.3390/nu17152545.

106. Ma, J.; Li, P.; Jiang, Y.; Yang, X.; Luo, Y.; Tao, L.; Guo, X.; Gao, B. The Association between Dietary Nutrient Intake and Acceleration of Aging: Evidence from NHANES. Nutrients 2024, 16, 1635. https://doi.org/10.3390/nu16111635

107. Zhang B, Zhang X, Ma L, Li D, Li Y, Lin S, Peng L, He L. Interpretable machine learning with SHAP analysis identifies redox-modulating dietary antioxidants for predicting accelerated biological aging. Exp Gerontol. 2026 Jul;220:113168. doi: 10.1016/j.exger.2026.113168. 

108. Te L, Liu J, Ma J, Wang S. Correlation between serum zinc and testosterone: A systematic review. J Trace Elem Med Biol. 2023 Mar;76:127124. doi: 10.1016/j.jtemb.2022.127124.

109. Akbari H, Elyasi L, Khaleghi AA, Mohammadi M. The effect of zinc supplementation on improving sperm parameters in infertile diabetic men. J Obstet Gynaecol India. 2023 Aug;73(4):316-321. doi: 10.1007/s13224-023-01767-7.

110. Zečević N, Veselinović A, Perović M, Stojsavljević A. Association Between Zinc Levels and the Impact of Its Deficiency on Idiopathic Male Infertility: An Up-to-Date Review. Antioxidants (Basel). 2025 Jan 29;14(2):165. doi: 10.3390/antiox14020165.  

111. GamalEl Din SF, A M E, Elkhiat Y, Hussein T, AbdElSalam MA, Alam A, Ramzy D, Moatamed I, Zeidan A, Elahwany A, Ragab MW, Zahran O, Saad H. Evaluation of in vivo supplementation of 2660 mg D-aspartic acid and 200 mg ubiquinol and 10 mg zinc on different semen parameters in idiopathic male infertility: a randomized double blind placebo controlled study. Arch Ital Urol Androl. 2025 Jun 30;97(2):13554. doi: 10.4081/aiua.2025.13554.

112. Rochdi C, Ouadrhiri M, Allai L, Bellajdel I, Mamri S, Taheri H, Saadi H, Mimouni A, Choukri M. Beneficial effects of oral antioxidant supplementation on semen quality parameters, reproductive hormones, and sperm DNA integrity in men with idiopathic oligoasthenoteratozoospermia. Clin Exp Reprod Med. 2024 Jun;51(2):135-141. doi: 10.5653/cerm.2023.06555.

113. Salonia A, Capogrosso P, Boeri L, Cocci A, Corona G, Dinkelman-Smit M, Falcone M, Jensen CF, Gül M, Kalkanli A, Kadioğlu A, Martinez-Salamanca JI, Afonso Morgado L, Russo GI, Serefoğlu EC, Verze P, Minhas S. European Association of Urology Guidelines on Male Sexual and Reproductive Health: 2025 Update on Male Hypogonadism, Erectile Dysfunction, Premature Ejaculation, and Peyronie's Disease. Eur Urol. 2025 Jul;88(1):76-102. doi: 10.1016/j.eururo.2025.04.010.

114. Khera M, Torres LO, Grober ED, Morgentaler A, Miner M, Jones TH, Mills JN, Salonia A. Male hypogonadism: recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024). Sex Med Rev. 2025 Oct 4;13(4):548-573. doi: 10.1093/sxmrev/qeaf036. 

115. Jimbo M, Gomella LG. Ipogonadismo maschile. Manuale MSD versione per i professionisti. 2026. https://www.msdmanuals.com/it/professionale/malattie-endocrine-e-metaboliche/endocrinologia-della-riproduzione-maschile-e-disturbi-associati/ipogonadismo-maschile

116. Mini-review Testosterone e salute maschile 2026 https://www.mitochon.it/testosterone-salute-maschile-e-ruolo-della-nutraceutica-selettiva/?v=0d149b90e739