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Related Experiment Videos

Age-related changes in male gonadal function. Implications for therapy

D Maas1, A Jochen, B Lalande

  • 1Department of Medicine, Medical College of Wisconsin, Milwaukee, USA.

Drugs & Aging
|July 1, 1997
PubMed
Summary

Aging men generally maintain testosterone production, but some studies show a decline. Testosterone replacement therapy offers benefits but carries risks, requiring cautious use in older men with hypogonadism.

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Area of Science:

  • Endocrinology
  • Aging Research
  • Men's Health

Background:

  • Men experience gradual decline in testosterone production with aging, unlike women's menopause.
  • Cross-sectional studies suggest a partial decrease in testosterone levels in aging men, but findings are inconsistent.
  • Discrepancies in studies are attributed to variations in design, sample size, assays, and patient selection.

Purpose of the Study:

  • To explore the age-associated changes in male testosterone production.
  • To review potential mechanisms behind declining testosterone levels in aging men.
  • To evaluate the benefits and risks of testosterone replacement therapy (TRT) in hypogonadal men.

Main Methods:

  • Review of existing cross-sectional and observational studies on aging and male hormone levels.

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  • Analysis of proposed physiological and environmental factors contributing to testosterone decline.
  • Assessment of evidence for and against testosterone replacement therapy in older men.

    • Main Results:

    • While testicular androgen production is largely maintained, a partial decrease in testosterone levels with aging is reported in some studies.
    • Potential causes for age-related testosterone decline include hypothalamic-pituitary-testicular axis defects, increased sex hormone-binding globulin, environmental factors, medications, and chronic illness.
    • TRT may improve bone density, muscle strength, well-being, and metabolic profile in hypogonadal men.

    Conclusions:

    • Testosterone replacement therapy in hypogonadal men offers potential benefits but requires careful consideration of risks like erythrocytosis, sleep apnea, and prostate issues.
    • Androgen replacement should be administered cautiously in elderly men with hypogonadism pending results from rigorous prospective studies.
    • Further well-controlled research is necessary to establish definitive guidelines for TRT in aging men.