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The male climacterium

A Vermeulen1

  • 1Department of Endocrinology, University Hospital, Ghent, Belgium.

Annals of Medicine
|December 1, 1993
PubMed
Summary
This summary is machine-generated.

Male fertility declines with age, leading to symptoms similar to menopause. However, androgen levels often remain normal in older men, and risks of hormone replacement therapy, like prostate cancer, outweigh benefits. Androgen therapy is not recommended for elderly men.

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Area of Science:

  • Gerontology
  • Andrology
  • Endocrinology

Background:

  • Male fertility persists into old age, unlike female fertility.
  • Aging men experience decreased testicular function (exocrine and endocrine).
  • Symptoms in aging men are analogous to, but less severe than, menopause, termed male climacterium or andropause.

Purpose of the Study:

  • To evaluate the clinical significance of age-related decline in male testicular function.
  • To assess the potential benefits and risks of androgen substitution therapy in elderly men.

Main Methods:

  • Comparative analysis of hormonal changes in aging men versus young men.
  • Review of existing studies on hormonal replacement therapy in postmenopausal women and elderly men.
  • Assessment of potential risks associated with androgen therapy in elderly men, particularly regarding prostate health.

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Main Results:

  • Biologically active androgen (free testosterone) levels decrease moderately in elderly men.
  • Many elderly men maintain free androgen levels within the normal range for younger men.
  • Unlike menopause, ovarian hormone secretion ceases almost completely, whereas androgen decline is less pronounced.

Conclusions:

  • The risk-benefit balance of androgen substitution in elderly men is not yet established by well-controlled studies.
  • A significant risk of androgen therapy is the potential stimulation of subclinical prostatic carcinoma in elderly men.
  • Generalized androgen substitution in elderly men is not currently recommended due to unproven benefits and potential risks.