Age-related changes in male gonadal function. Implications for therapy.

Abstract:

:In contrast with women, who experience a complete and abrupt cessation of ovarian function during the menopause, aging men largely maintain their testicular androgen production. Nevertheless, most cross-sectional studies indicate that there is a partial decrease in testosterone levels with aging, although this has not been confirmed by other studies. The disparity among studies stems from differences in study design, patient numbers, assay techniques and inclusion criteria. Proposed mechanisms for an age-associated decline in testosterone production include: (i) defects in the hypothalamic-pituitary-testicular axis; (ii) an increase in sex hormone binding globulin levels; (iii) environmental factors; (iv) medication use; and (v) chronic illness. The potential beneficial effects of testosterone replacement therapy in hypogonadal men include increased bone density, increased muscle strength, an improved feeling of well-being and an improved metabolic profile. These benefits need to be weighted against the potential risks of androgen therapy, such as erythrocytosis, sleep apnoea, and the stimulation of benign prostatic hypertrophy or an occult prostate malignancy. Consequently, androgen replacement should be used with caution in elderly men with hypogonadism until the results of well-controlled prospective studies are available.

journal_name

Drugs Aging

journal_title

Drugs & aging

authors

Maas D,Jochen A,Lalande B

doi

10.2165/00002512-199711010-00005

subject

Has Abstract

pub_date

1997-07-01 00:00:00

pages

45-60

issue

1

eissn

1170-229X

issn

1179-1969

journal_volume

11

pub_type

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