Physical Exercise as a Sustainability Tool in Men With Dysmetabolic Hypogonadism

Inclusion Criteria: * diagnosis of late-onset central hypogonadism: total T levels \< 8 nmol/L (or \< 12 nmol/L in the presence of calculated free T \< 225 pmol/L) combined with sexual symptoms (erectile dysfunction, low libido and loss of waking erections) \[12\]; * diagnosis of metabolic syndrome, defined as association of waist circumference (WC) \> 94 cm and at least two among the following criteria: triglycerides ≥ 150 mg/dl, HDL-C \< 40 mg/dl, glucose \> 100 mg/dl, blood pressure (BP) ≥ 130/85 mmHg \[33\]; * ability to give informed consent, in accordance with good clinical practice rules and applicable national laws. Exclusion Criteria: * History of hypothalamus-pituitary organic disorders and/or testicular diseases; * impossibility to assess cardiac autonomic regulation due to arrhythmias and/or current treatment for heart rate (HR) control (e.g., beta-blockers, antiarrhythmics); * impossibility to undergo clinical assessment; * impossibility or contraindications to perform exercise program (for instance, psychiatric disorders, severe musculoskeletal diseases, arrhythmias); * inability to give informed consent or unwillingness to be enrolled in the study.