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[The male climacteric. A responsibility for dermatologic andrology?]
1Abteilung Andrologie, Klinikum der Philipps-Universität Marburg.
Insights
Male sexual impotence, a key symptom of male climacteric, is linked to aging and disease impacting testosterone levels. Sexual function decline in aging men may not directly correlate with testosterone reduction.
Area of Science:
- Endocrinology
- Andrology
- Gerontology
Context:
- The male climacteric, analogous to female menopause, presents with sexual impotence as a primary symptom.
- Unlike female menopause, male climacteric lacks established treatment institutions.
- Testosterone production declines with age, influenced by disease in aging men.
Purpose:
- To investigate the relationship between aging, disease, and testosterone levels in men.
- To analyze the Massachusetts Male Aging Study data on hormone levels and age.
- To explore the endocrine basis of the male climacteric and associated sexual dysfunction.
Summary:
- The Massachusetts Male Aging Study found mean testosterone levels decrease by 1% and free testosterone by 1.2% annually.
- Disease significantly impacts testosterone decline in aging men more than age alone.
- Sexual dysfunction frequency increases with age, partly due to drug interactions.
Impact:
- Findings inform potential hormone substitution recommendations for aging men.
- Highlights the need to explore non-endocrine factors for the male climacteric and mid-life crisis.
- Emphasizes the distinction between age-related testosterone decline and sexual function in aging males.
Abstract:
Sexual impotence is considered to be the main symptom of the male climacteric, corresponding to the female menopause. While the female climacteric is routinely observed and treated by gynecologists, there are no adequate institutions for the treatment of the corresponding male complaints. Like ovarian secretion of estrogens, which declines and thus causes the female climacteric syndrome, the endocrine metabolism of the testes decreases with increasing age. The period of this decrease, however, is far more extended than that of estrogen secretion in women. Several recent studies have yielded evidence that any disease--irrespective of its kind--in the aging man influences the decrease of testosterone levels more markedly than his age. In 1986 a study group in New England inaugurated the "Massachusetts Male Aging Study" in which healthy men in different age groups were tested for hormone levels. The most prominent result of this study was a decrease in mean testosterone levels by 1% and a decrease in the mean free testosterone levels by 1.2% per year of age. The study also allows recommendations for hormone substitution. The decrease in sexual function in the aging male does not correlate with the decrease in testosterone production. In summary, however, there is no doubt that the frequency of sexual dysfunction increases with advancing age, partly because of drug interactions. As there does not seem to be any sound basis for assuming an endocrine basis for the male climacteric, other reasons must probably be sought for the male climacteric or mid-life crisis.(ABSTRACT TRUNCATED AT 250 WORDS)