[Evidence based medicine with reference to the aging man]

There is increasing public and medical interest in the physiological changes of the ageing male. The intention for prolongation of life in combination with maintenance of physical and mental fitness are a great challenge for modern medicine. There are known alterations in the hormonal profiles of ageing males supporting the hypothesis of hormonal substitution to increase quality of life and even to prolong life. These therapies must be faced with the performance of evidence-based medicine defined by the combination of clinical experience with available scientific results including experimental and clinical investigations. There are several systems involved in the ageing process but the pathophysiological background for these changes is not completely understood. Some controlled, randomised studies reported positive effects of hormonal therapy in the ageing male but only a few investigated sufficient patients over a longer period. Due to the lack of long-term data, analysis of the literature for the application of evidence based medicine cannot be sufficiently done yet. It is necessary to perform experimental studies and clinical investigations on clearly defined questions concerning the ageing male including high number of patients over long term treatment periods to get sufficient data to evaluate the value of hormonal substitution in the ageing male according to evidence-based medicine criteria for the performance of best patient's care.