Is There a Clinical Relevance of Partial Androgen Deficiency of the Aging Male?

Christ‐Crain, Mirjam; Müeller, Beat; Gasser, Thomas C.; Kraenzlin, Marius; Trummler, Michael; Huber, Peter; Meier, Christian

doi:10.1097/01.ju.0000135303.96496.ee

Cited by 44 publications

(29 citation statements)

References 21 publications

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“…Although Chinese cohort studies have tried to establish androgen defi ciency risks by using the IIEF-5 (28), in the majority of studies (29)(30)(31) including the Massachusetts Male Aging Study (MMAS), this correlation was not demonstrated (32). A possible explanation for the differences in these results was suggested in Mikhail's review (33).…”

Section: Discussionmentioning

confidence: 82%

Risk of late-onset hypogonadism (andropause) in Brazilian men over 50 years of age with osteoporosis: usefulness of screening questionnaires

Clapauch¹,

Braga²,

Marinheiro³

et al. 2008

Arq Bras Endocrinol Metab

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Objective: To analyze the relative risk of late-onset hypogonadism in men with osteoporosis and the usefulness of screening questionnaires. Methods: We correlated the Aging Male's Symptoms (AMS), Androgen Defi ciency in Aging Male (ADAM) and International Index of Erectile Function (IIEF-5) questionnaires and the laboratory diagnosis of hypogonadism in 216 men aged 50-84 years (110 with osteoporosis and 106 with normal bone density, paired by age and ethnicity). Results: Hypogonadism presented in 25% of the osteoporotic and in 12.2 % of normal bone density men (OR 2.08; IC95%: 1.14-3.79) and was associated with ADAM fi rst question (low libido, p=0.013). Levels of TT below 400 ng/dl correlated with an AMS score above 26 (p=0.0278). IIEF-5 showed no correlation with testosterone levels. Conclusion: Hypogonadism was 2.08 times more prevalent in osteoporotic men. The symptom that best correlated with late-onset hypogonadism was low libido (ADAM 1 positive).

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Section: Discussionmentioning

confidence: 82%

Risk of late-onset hypogonadism (andropause) in Brazilian men over 50 years of age with osteoporosis: usefulness of screening questionnaires

Clapauch¹,

Braga²,

Marinheiro³

et al. 2008

Arq Bras Endocrinol Metab

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“…Other screening questionnaires have similar constraints. 12,13 In the elderly, the diagnosis of hypogonadism is more problematic because of the difficulty in determining the extent of symptoms caused by aging, hypogonadism or both. 10 Symptomatology provides only 48% sensitivity and 66% specificity for diagnosing hypogonadism.…”

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confidence: 99%

The relationship between hypogonadism and erectile dysfunction

Hwang

Lin

2008

Int J Impot Res

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It is well known that testosterone enhances sexual interest leading to an increased frequency of sexual acts and an increase in the frequency of sleep-related erections. However, it has little effect on fantasy-or visually induced erections. Exact contribution to erection from testosterone in men remains unclear. Animal studies have well demonstrated that testosterone plays critical physiological (activity of nitric oxide synthases and phosphodiesterases), biochemical (through an endothelial-independent pathway and adrenergic tonicity) and structural (change of fibroelasticity and hollow cell accumulation) roles in erectile function. The supplementation of testosterone to castrated animals can restore erectile function. Clinically, reports of patients with erectile dysfunction (ED) combined with hypogonadism who receive testosterone therapy have inconsistent results. However, testosterone may ameliorate the expression of the phosphodiesterase-5 (PDE5) inhibitor, and the use of testosterone in conjunction with the PDE5 inhibitor revealed convincing results. Because of potential risks in clinical use, testosterone therapy should be individualized, carefully considered and closely monitored, especially, in patients with possible occult prostate cancer, and large benign prostatic hyperplasia. Lower urinary tract symptoms might be worsened by this treatment, since the prostate is an androgen-dependent tissue.

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“…Clinical features suggestive of hypogonadism in the aging male Table 1 footnote. 18 There is sparse evidence concerning ethnic variation in male sex hormones. In a recent study, TT, cFT, and SHBG were lower in Pakistani men than in Afro-Caribbean and Caucasian men living in England.…”

Section: Discussionmentioning

confidence: 99%

Hormone levels in middle-aged and elderly men with and without erectile dysfunction in Taiwan

et al. 2005

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The change in sexual hormones with age in middle-aged and elderly Chinese men, with and without erectile dysfunction (ED), was investigated. Total testosterone (TT), free testosterone (FT), dehydroepiandrosterone sulfate (DHEAS), and sex hormone-binding globulin (SHBG) were determined from fasting serum samples by radioimmunoassay in 627 middle-aged and elderly ethnic Chinese men with and without ED. Calculated FT was derived from TT and SHBG. Patients with ED were subdivided into groups having low serum TT (o2.7 ng/ml) and normal TT (X2.7 ng/ ml). FT and DHEAS declined and SHBG rose with age in both normal patients and in patients with ED. TT and SHBG were lower in patients with ED than in normal subjects at all ages. In contrast to findings in previous studies, levels of FT were higher in patients with ED than in normal subjects. Hormonal changes in this Chinese population generally mirrored those in previously studied ethnic populations, except for higher FT in patients with ED. This suggests that hormonal levels in patients with ED may vary in different populations. The significance and reproducibility of this finding remains to be determined.

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Is There a Clinical Relevance of Partial Androgen Deficiency of the Aging Male?

Abstract: T values in our study sample did not correlate with clinical signs and symptoms of hypogonadism. Thus, according to our data, symptoms of the aging male could be rather multifactorial and should not be indiscriminately assigned to the age associated decrease in T levels.

Cited by 44 publications

References 21 publications

Risk of late-onset hypogonadism (andropause) in Brazilian men over 50 years of age with osteoporosis: usefulness of screening questionnaires

Risk of late-onset hypogonadism (andropause) in Brazilian men over 50 years of age with osteoporosis: usefulness of screening questionnaires

The relationship between hypogonadism and erectile dysfunction

Hormone levels in middle-aged and elderly men with and without erectile dysfunction in Taiwan

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