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2007, Número 1

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Rev Endocrinol Nutr 2007; 15 (1)


Deficiencia de andrógenos en el adulto de edad avanzada

Morato HML, Porias CHL, Lamm WL

Idioma: Español
Referencias bibliográficas: 61
Paginas: 37-48
Archivo PDF: 171.51 Kb.


RESUMEN

El diagnóstico de la deficiencia parcial de testosterona en el adulto mayor no resulta tan simple como lo que ocurre en la mujer en el momento de presentar la menopausia. La sintomatología puede iniciarse a los 50 años aunque es más común después de los 60; e implica una serie de cambios a nivel emocional, cognoscitivo, así como cambios en la estructura corporal como es la tendencia al aumento de la grasa y reducción de la masa muscular. En el área sexual es evidente la reducción de la calidad de la erección, la reducción de la libido amén de otras alteraciones. Aun cuando en algunos casos resulta sencillo correlacionar los datos con un cuestionario específico y la reducción de los niveles de testosterona total y testosterona libre existe un sinnúmero de casos en los cuales los niveles hormonales son aparentemente normales y da lugar a la pregunta lógica: Es válido tratar esos casos o hay que “esperar” a que los niveles rebasen el límite inferior del rango normal (que entre paréntesis no ha sido establecido mundialmente). Las consecuencias del descenso androgénico repercuten además en diversas áreas como son el esqueleto (tendencia a la osteoporosis), menor resistencia y fuerza muscular (tendencia a la sarcopenia), mayor riesgo cardiovascular y desde luego cambios emocionales y afección en el área sexual. La posibilidad de tratamiento queda abierta bajo las premisas de riesgos y beneficios con la tendencia mundial a poder brindarle al varón una mejor calidad de vida ante la inminente posibilidad de vivir más años que en las décadas anteriores.


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