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2007, Number 1

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Rev Endocrinol Nutr 2007; 15 (1)

Androgen deficiency in the aging male

Morato HML, Porias CHL, Lamm WL

Language: Spanish
References: 61
Page: 37-48
PDF size: 171.51 Kb.


ABSTRACT

Andropause is a process that involves properly a simple decrease in the testosterone levels so that the proper definition may be a partial androgen deficiency in the aging male. This event may occurs in the early 50 or more in the 60 years of the male and is possible to be detected by a simple questionnaire. However if the testosterone level is in correlation with the symptoms the procedure is easy and therapy is based on strong clinical evidence. Many cases reflect the reduction of muscular mass and increase of body fat, osteopenia or osteoporosis, emotional and cognoscitive disturbances and obviously sexual alteration such as libido reduction and minor quality in the erectile function. It is difficult to have a real diagnosis based on hormonal determination since the low level of total testosterone has not been really determined. If the male has many data in the questionnaire and low but normal testosterone levels the decision of initiating testosterone therapy is still controversial. The medical experience may help to evaluate risks and benefits to help in order to improve the quality of life.


REFERENCES

  1. Werner AA. The male climateric. JAMA 1939; 112: 1441-1443.

  2. Gooren LG. The age-related decline of androgen levels in men; clinicallly significant? Br J Urology 1996; 78: 763-768.

  3. The Endocrine Society: 2nd. Annual consensus meeting on andropause. J Clin Endoc Metab 2001.

  4. Matsumoto AM. Fundamental aspects of hypogonadism in the aging male. Rev Urology 2003; 5(1): S3-S10.

  5. INEGI 2005.

  6. Vermeulen A, Verdonck L, Kaufman JM. A Critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocr Metab 1999; 84(10): 3666-3672.

  7. Morales A, Heaton JPW, Carson CC. Andropause: A misnomer for a true clinical entity. J Urology 2000; 163: 705-712.

  8. Castro-Acuña V, Martínez-Martínez L, Larrea F. Deficiencia parcial de andrógenos en el varón. Rev Invest Clin 2004; 56(4): 507-512.

  9. Keenan DM, Veldhuis JD. Disruption of the hypothalamic luteinizing hormone pulsing mechanism in the aging men. Am J Physiol Regulatory Integrative Comp Physiol 2001; 281: R1917-R 1924.

  10. Baulieu EE, Thomas G, Legrain S et al. D Dehydroepiandrosterone (DHEA), DHEA sulfate, and aging: Contribution of the DHEAge Study to a sociobiomadical issue. PNAS 2000, 97(8): 4279-4284 (www.pnas.org).

  11. Laughlin GA, Barret-Connor. Sexual dismorphism in the influence of advanced aging on adrenal hormone levels: The Rancho Bernardo Study. J Clin Endoc Metab 2000; 85(10): 3561-3568.

  12. Vermeulen A. Andropause. Maturitas 2000; 34: 5-15.

  13. Morley JE. Androgens and aging. Maturitas 2001; 38: 61-73.

  14. Bhasin S, Bagatell CJ, Bremner WJ et al. Issues in testosterone replacemente in older men. J Clin Endoc Metab 1998; 83: 3435-3448.

  15. Testosterone therapy in adult men with androgen deficiency syndrome 2006 www.endoscoiety.org/quickcontent/clinicalpractice/clinical-guidances/GH_ clinicalguidance,cfm.

  16. Alexandersen P, Christiansen C. The aging male: testosterone deficiency and testosterone replacement. An up-date. Atherosclerosis 2004; 173: 157-169.

  17. Behre HM, Kleisch S, Leifke E, Link TM, Neischlag E. Long-term effect of testosterone therapy in bone mineral density in hypogonadal men. J Clin Endocrinol Metab 1997; 82: 2386-2390.

  18. Snyder PJ, Peachey H, Berlin JA, Hannoush P, Haddad G et al. Effects of testosterone replacement in hypogonadal men. JCEM 2000; 85: 2670-2677.

  19. Johannes CB, Araujo AB, Feldmann HA et al. Incidence of erectile dysfunction in men 40-69 years old: longitudinal results from the Massachusetts Male Aging Study. Journal of Urology 2000; 163: 460-463.

  20. McKinlay JB, Longcope C, Gray A. The questionable physiologic and epidemiologic basis for a male climacteric syndrome: preliminary results from the Massachusetts Male Aging Study. Maturitas 1989; 11: 103-115.

  21. Aversa A, Isidori AM, Spera G, Lenzi A, Fabbri A. Androgens improve cavernous vasodilatation and response to sildenafil in patients with erectile disfunction. Clin Endocrinol (Oxf) 2003; 58: 632-638.

  22. Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR. Longitudinal effects of aging on serum total and free testosterone levels in healthy men. J Clin Endoc Metab 2001; 86(2): 724-731.

  23. Simon D, Charles MA, Nahou K, Orssaud G, Kremski J et al. Association between plasma total testosterone and cardiovascular risk factors in healthy adult men: The Telecom study J Clin Endocrinol Metab ISSN 0021-972X.

  24. Rosano GM, Leonardo F, Pagnotta P. Acute anti-ischemic effect of testosterone in men with coronary artery disease. Circulation 1999; 99: 1666-1670.

  25. Von Eckerstein A. l Testosterone and cardiovascular disease. In: Nieschlag E and Behre HM (eds). Testosterone action deficiency and substitution. 3nd edn Cambridge University press 2004: 297-331.

  26. PhillipsGB. Sex hormones risk factor and cardiovascular disease. Am J Med 1978; 65: 7-11.

  27. Marin P, Kvist H, Lindstedt G, Sjostrom LP. The effects of testosterone on body composition and metabol. In middle aged men. In J Obesity 1992; 16: 991-997.

  28. Iranmaresh A. Unequal impact of age, percentage body fat and serum testosterone concentrations, IGF I and IGF binding protein responses to a three day intravenous growth hormone-releasing hormone pulsatil infusion in men. Eur J Endocrinol 1998; 139: 59-71 vascular disease in men. Clin Endocrinology 2005; 63: 239-242.

  29. Cherrier MM, Asthana S, Plymate S, Baker L, Matsumoto AM et al. Testosterone supplementation improves spatial and verbal memory in healthy older men. Neurology 2001; 57: 80-88.

  30. Gray B, Singh AB, Woodhouse LJ, Storer TW, Casaburi J et al. Testosterone, sexual function, and cognition. J Clin Endocrinol Metab 2005; 90: 3838-3846.

  31. Cherrier MM, Matsumoto AM, Amory JK, Asthana W. Testosterone improves spatial memory in men with Alzheimer disease and mild cognitive impairment. Neurology 2005; 64(12): 2063-2068.

  32. Okun MS, Crucian GP, Fischer L, Walter BL, Testa CM et al. Testosterone deficiency in a Parkinson’s disease clinic: results of a survey. J Neurol Neurosurg & Psych 2004; 75: 165-166.

  33. Okun MS, Walter BL, McDonald WM et al. Beneficial effects of testosterone replacement for the non-motor symptoms of Parkinson disease. Arch Neurol 2002; 59: 1750-3.

  34. Sonntag WE, Ramsey M, Carter CS. Growth hormone and insulin-like growth factor-1 (IGF-1) and their influence on cognitive aging. Ageing Res Rev 2005; 2: 195-212.

  35. Vance ML, Mauras N. Drug therapy: Growth hormone therapy in adults and children. New Eng J Med 1999; 341: 1206-1216.

  36. Nieschlag E, Behre HM. Pharmacology and clinical uses of testosterone. In: testosterone deficiency substitution. 2nd edition Berlin: Springer Verlag 1998: 329.

  37. Gooren LJG. A ten-year safety study of the oral androgen testosterone undecanoate. J Androl 1994; 15: 212-215.

  38. Blackman MR, Sorkin JD, Munzer T, Bellantoni MF, Busby J et al. Effects of growth hormone and sex steroid administration in healthy aged men and women. JAMA 2002; 288: 2282-2292.

  39. Morley J, Charlton E, Patrick P et al. Validation of a screening questionnaire for androgen deficiency in aging males. Metabolism 2000; 49(9): 1239-1242.

  40. Tenover JL. Testosterone and the aging male. Journal of Andrology, Vol 18, Issue 2 103-106, Copyright © 1997 by The American Society of Andrology.

  41. Griggs RC, Kingston W, Jozefowicz RF, Herr BE, Forbes G, Halliday D. Effect of testosterone on muscle mass and muscle protein synthesis J Appl Physiol 1989; 66: 498-503,

  42. Depenbusch M, von Eckardstein S, Simoni M et al. Maintenance of spermatogenesis in hypogonadotropic hypogonadal men with human chorionic gonadotropin alone. Eur J Endocrinol (England) 2002; 147(5): 617-624.

  43. Heinemann LAJ, Zimmermann T, Vermeulen A et al. A New aging males´symptoms rating scale. Ageing Male 2001; 2: 105-114.

  44. http://www.issam.ch/freetesto.htm

  45. Barret-Connor E, Mueller JEG, von Mühlen D, Schneider DL, Sartoris DJ. Low levels of estradiol are associated with vertebral fractures in older men, but not women: The Rancho Bernardo Study.1 The Journal of Clinical Endocrinology & Metabolism 2000; 85: 219-223.

  46. Kaufman JM, Vermeulen A. Androgens in male senscense chapter 16 in testosterone action deficency and substitution. (E Nieschlag H M Behre Edits) Springer Verlag 2nd edition 1998: 437-471.

  47. Sinha HI, Arver S, Beall G, Shen R, Guerrero M et al. The use of a sensitive equilibrium dialysis method for the measurement of free testosterone levels in healthy, cycling women and in human immunodeficiency virus-infected women.1 J CLin Endocrinol Metab 1998; 83: 1312-1318.

  48. Giton F, Fiet J, Geuchot J, Ibrahim F, Bronsard F et al. Serum Bioavailable testosterone: Assayed or calculated? Clin Chem 2006; 52(3): 474-481.

  49. Dechaud H, Lejeune H, Chollet M, Mallein R, Pugeot M. Radioimmmunoassay of testosterone not bound to sex steroid binding globulin in plsma. Clin Chem 1989; 35: 1609-14.

  50. Nieschlag E. Investigation, treatment, and monitoring of late-onset hypogonadism in males: ISA. J Androl 2006; 27: 135-137.

  51. Lamm WL, Porias CH. Clinical data of androgen deficiency may be more precise that the testosterone and free testosterone in order to indicate treatment. The aging male 2005 congress Vancouver Can.; abstract 79.

  52. Porias CH, Lamm WL. Estudio del hipogonadismo relativo en adultos, mediante la aplicación de una encuesta y su correlación con las concentraciones de hormonas masculinas como base para el diagnóstico de andropausia. Revista del Climaterio 2003; 34: 157-65.

  53. Bashin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ et al. Testosterone therapy in adult men with androgen deficiency syndromes: An Endocrin Society Clinical Practice Guideline. J Clin Endocrinol Metab 2006; 91: 1995-2010.

  54. Morales AA. Andropause: facts fictions and controversies. The Aging Male 2004; 7: 297-303.

  55. Bhasin S. Testosterone replacement increases fat free mass and muscle size in hypogondal men. JCEM 1997; 82: 407-413.

  56. Kapoor D, Malkint CJ, Channert KS, Jones TH. Androgen, insulin resistance and vascular disease in men. Clin Endocrinology 2005; 63: 239-42.

  57. Luukkaa V. Inverse correlation between serum testosterone and leptin in men. J Clin Endocrinol Metab 1998; 83: 3242-3246.

  58. Laaksonen DE, Niskanen L, Punnonen K, Nyyssonen K, Tuornainene TT. Testosterona and sex hormona-binding globuline predict the metabolic syndrome and diabetes in middle–aged men. Diabetes Care 2004; 27: 1036-1040.

  59. Boyanov MA. Testosterone supplementation in men with type 2 diabetes, visceral obesity and partial androgen deficiency. The Aging Male 2003; 1: 1-7.

  60. Jee-Young OH, Barrett-Connor E, Wedick NE, Wingard DL. Rancho Bernanrdo study endogenous sex hormones and development of type 2 diabetes in older men and women. The Rancho Bernardo Study. Diabetes Care 2002; 25: 55-60.

  61. Klentze M. (Klentze Institute of anti-Aging, Munich, Germany) Testosterone: The male hormonal connection Treating diabetes and heart disease www.worldhealth.net/pdf/bookstore/thera6_ch7.pdf




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