Andropause
- PMID: 10687877
- DOI: 10.1016/s0378-5122(99)00075-4
Andropause
Abstract
Although, in distinction to middle aged women, in middle aged men there does not occur a sudden arrest of gonadal functions, fertility persisting until very old age, aging in men is, nevertheless, associated with an gradual decline of both endo- and exocrine testicular function. Whereas age has in fact only minimal effects on the quality of the ejaculate, endocrine function declines steadily with age and at age 75 years, mean plasma testosterone levels are only 65% of levels in young adults whereas over 25%, of these men have bioavailable testosterone levels below the lower normal limit in young adults. The interindividual variations in the plasma levels are, however, very important and a quarter of men over 75 years old, have still testosterone levels within the upper quartile of values in young men. Aging is accompanied by a series of signs and symptoms, many of which are rather similar to those observed in young hypogonadal males. The etiology of these signs and symptoms is often multifactorial, and very few correlations have been found between symptoms and plasma testosterone levels. Nevertheless, there is good evidence that the age associated decrease in testosterone levels is at least a co-determinant of these symptoms and testosterone supplementation has shown favorable effects on many of them. Side effects of this substitutive therapy are minimal when care is taken to keep plasma testosterone levels within the physiological range. Clinical prostatic carcinoma is an absolute contra-indication for testosterone supplementation. So far, there are no indications that testosterone would stimulate the evolution of as subclinical prostatic carcinoma to a clinical carcinoma but it should be recalled that so far, only a small number of elderly males received substitutive androgen treatment for longer periods in controlled studies. Hence, although side effects are generally minimal, one should, nevertheless, await the results of larger, long term, well-controlled studies before to recommend the routine testosterone substitution of elderly men.
Similar articles
-
Testosterone supplementation therapy as a treatment of hypogonadism.Bratisl Lek Listy. 2009;110(12):765-72. Bratisl Lek Listy. 2009. PMID: 20196470 Review.
-
The male climacterium.Ann Med. 1993 Dec;25(6):531-4. Ann Med. 1993. PMID: 8292301 Review.
-
The decline of androgen levels in elderly men and its clinical and therapeutic implications.Endocr Rev. 2005 Oct;26(6):833-76. doi: 10.1210/er.2004-0013. Epub 2005 May 18. Endocr Rev. 2005. PMID: 15901667 Review.
-
Neuroendocrine aging in men. Andropause and somatopause.Endocrinol Metab Clin North Am. 2001 Sep;30(3):647-69. doi: 10.1016/s0889-8529(05)70206-1. Endocrinol Metab Clin North Am. 2001. PMID: 11571935 Review.
-
[Senile hypogonadism in man and hormone replacement therapy].Acta Med Austriaca. 2000;27(1):11-7. doi: 10.1046/j.1563-2571.2000.200103.x. Acta Med Austriaca. 2000. PMID: 10812457 Review. German.
Cited by
-
Depression in Women: Potential Biological and Sociocultural Factors Driving the Sex Effect.Neuropsychobiology. 2024;83(1):2-16. doi: 10.1159/000531588. Epub 2024 Jan 25. Neuropsychobiology. 2024. PMID: 38272005 Free PMC article. Review.
-
Validity and Reliability of the Turkish Male Andropause Symptoms Self-Assessment Questionnaire.J Midlife Health. 2023 Jan-Mar;14(1):21-27. doi: 10.4103/jmh.jmh_196_22. Epub 2023 Jul 7. J Midlife Health. 2023. PMID: 37680371 Free PMC article.
-
First Evidence Indicates the Physiology- and Axial-Myopia-Dependent Profiles of Steroid Hormones in Aqueous Humor.Metabolites. 2022 Dec 5;12(12):1220. doi: 10.3390/metabo12121220. Metabolites. 2022. PMID: 36557258 Free PMC article.
-
Advanced Paternal Age and Future Generations.Front Endocrinol (Lausanne). 2022 Jun 9;13:897101. doi: 10.3389/fendo.2022.897101. eCollection 2022. Front Endocrinol (Lausanne). 2022. PMID: 35757433 Free PMC article. Review.
-
The Relation Between Steroid Secretion Patterns and the Androgen Receptor Gene Polymorphism on Physical Health and Psychological Well-Being-Longitudinal Findings From the Men's Health 40+ Study.Front Hum Neurosci. 2020 Feb 14;14:43. doi: 10.3389/fnhum.2020.00043. eCollection 2020. Front Hum Neurosci. 2020. PMID: 32116617 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical