[Hormone therapy in the aging male. Estrogen, DHEA, melatonin, somatotropin]

Area of Science:

• Endocrinology
• Aging Male Physiology

Context:

• The aging male endocrine system exhibits changes in hormones like dehydroepiandrosterone (DHEA), melatonin, and growth hormone.
• The distinction between physiological aging and true hormone deficiency is not well-defined.
• Current understanding of the clinical relevance of these hormonal shifts is limited.

Purpose:

• To investigate the significance and clinical relevance of age-related changes in male hormone concentrations.
• To evaluate the necessity of routine examination for hormones such as DHEA, melatonin, growth hormone, and IGF-1 in aging men with suspected late-onset hypogonadism.

Summary:

• Estrogen levels remain unchanged in aging males, while dehydroepiandrosterone (DHEA), melatonin, and growth hormone concentrations show alterations with age.
• These observed hormonal changes lack validated clinical significance according to ISSAM guidelines.
• There is insufficient evidence to support routine testing or hormone replacement therapy (except in specific cases like prostate cancer or male-to-female transsexualism) due to poorly understood effects and side effects.

Impact:

• Highlights the need for further research to clarify the clinical implications of hormonal changes in aging men.
• Discourages routine hormonal assessments and treatments for age-related endocrine shifts in men without established indications.
• Informs clinical practice regarding the investigation and management of late-onset hypogonadism in older males.