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The ageing male
1Department of Urology, Erasme Hospital University, Brussels, Belgium. claude.schulman@ulb.ac.be
World Journal of Urology
|June 29, 2002
Summary
Aging men experience hormone deficiencies, impacting urological health and mood. Testosterone replacement therapy can help, but requires careful monitoring and its link to prostate cancer remains undetermined.
Area of Science:
- Endocrinology
- Urology
- Gerontology
Background:
- Prolonged life expectancy leads to extended periods of hormone deficiency for both men and women.
- Aging males face increased risks of urological issues like benign prostatic hyperplasia (BPH), prostate cancer, incontinence, and erectile dysfunction.
- Distinguishing natural aging from illness-induced hormonal changes is complex.
Purpose of the Study:
- To review hormonal changes in aging males.
- To discuss associated health issues and available testosterone replacement therapies.
- To outline monitoring guidelines for testosterone therapy.
Main Methods:
- Review of literature on male aging, hormone levels, and associated conditions.
- Analysis of hormonal changes including testosterone, DHEA, growth hormone, and gonadotropins.
- Examination of the effects of hormonal changes on body composition, bone health, sleep, and mood.
Main Results:
- Aging males exhibit decreased testosterone, DHEA, growth hormone, and melatonin, with increased LH and FSH.
- Increased sex hormone-binding globulin (SHBG) further reduces free, biologically active testosterone.
- Hormonal shifts correlate with changes in body mass index, osteoporosis, sleep disturbances, and mood disorders.
Conclusions:
- Testosterone replacement therapies aim to restore physiological hormone levels, including metabolites like DHT and estradiol.
- Monitoring of men on testosterone therapy is recommended at 3-month intervals initially, then annually.
- The relationship between testosterone replacement and prostate cancer development requires further investigation.