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PubMed1990

Andrology today.

Andrology is an interdisciplinary field of medicine which developed in the second half of this century. Schirren was the first one to use this term. In Hungary, andrology was established by Jenö Molnár. Certain question of topical interest of andrology are discussed in the present study. Besides the endocrinologically well definable male hypogonadism caused by primary lesions of the hypothalamus-pituitary-testis-androgen periphery system andrological anomalies of known or unknown origin also occur in a great number of cases. As collective designation the use of "consecutive hypogonadisms" is recommended for these conditions. Other endocrine and non-endocrine disturbances, injuries of the male gonad system caused by drug therapy, environmental noxa and unknown factors may be ranged also into this group. In vitro fertilization applied in certain cases of infertility and cryostorage of human embryo pose several problems even to the andrologist. The development of an effective and harmless male contraceptive has to be realized in the future. The diagnosis of male climacteric may be assessed only after excluding other diseases. For the treatment of this condition low doses of androgen preparations are recommended.

Contraceptives, Oral↗

PubMed1985

The history of the male menopause 1848-1936.

The explicit intention of the majority of nineteenth and early twentieth century writers on the change of life was to dispel the aura of anxiety they believed surrounded the popular view of the menopause and to encourage middle-aged women (and their husbands) to regard the menopause as a necessary yet transitory phase through which the majority would pass to a higher and more fulfilling stage of life. These writers sometimes include references to the parallel problems of men, and from the latter part of the nineteenth century a distinct form of literature appears in Britain and the U.S.A. which portrays the male climacteric (or 'menopause') in a similar optimistic light. A central feature of this optimism is the gradual eroticisation of everyday life.

Female↗

PubMed1980

[Androgen therapy of impotentia coeundi in elderly men. Psychological and endocrinological investigations (author's transl)].

The aim of the present investigation was to assess impotence in elderly men by clinical, endocrinological and psychological examinations. Altogether 17 patients were treated in a double-blind study with placebo or 75 mg mesterolone per day over 8 weeks. The subjects were aged between 45 and 60 years and suffered from impotentia coeundi. No differences in serum LH and testosterone levels were noted between the start and end of therapy. Similarly, serum LH and testosterone levels in these patients did not differ from those in a control group. These results suggest that the "male climacteric" need not necessarily the associated with alterations in hormone parameters. On the other hand, mesterolone therapy resulted in an improvement in potency and other psychosomatic parameters.

Androgens↗

PubMedDate not supplied

Hot flushes in a male population aged 55, 65, and 75 years, living in the community of Linköping, Sweden.

OBJECTIVE: Hot flushes are as common in castrated men as in menopausal women. We investigated whether hot flushes exist in a normal aging male population and to what extent. DESIGN: A questionnaire was sent to all men living in Linköping, Sweden, who were 55, 65, and 75 years old ( = 1,885). The questionnaire asked for demographic data, medical history, mood status, medication, castrational therapy, and smoking, exercise, and alcohol habits, among other items. We asked specifically for current hot flushes unrelated to exercise or a warm environment. RESULTS: Of the questionnaires received, 1,381 were eligible for evaluation; 33 were analyzed separately because these men had been castrated. Hot flushes of any frequency were reported by 33.1% of noncastrated men, 4.3% reported flushes at least a few times per week, and 1.3% reported daily flushes. Half of the men reporting flushes were also bothered by them, ie, almost every sixth man in total. We found a relation between occurrence of hot flushes and other symptoms thought to be related to low testosterone concentration, such as decreased muscle strength or endurance, decreased enjoyment of life, sadness or grumpiness, and lack of energy ( < 0.05). CONCLUSIONS: Hot flushes occur in one third of a population of noncastrated older men, approximately half of whom consider flushes as bothersome. Neither the mechanisms nor whether the symptoms would respond to testosterone supplementation is known. Androgen substitution to treat symptoms possibly related to a male climacteric is still controversial. Studies are needed to evaluate the needs for and the effects of androgen treatment on vasomotor symptoms.

Age Distribution↗

PubMed1976

Estrogen-androgen levels in aging men and women: therapeutic considerations.

The influence of aging on serum levels of gonadotropins (FSH and LH), testosterone and estradiol was studied in the following groups: 4 normal men (ages 30 to 50), 38 men with symptoms of the male climacteric (ages 51 to 84), 25 men with relative impotence (ages 31 to 50), 10 normal women (ages 24 to 31), and 6 menopausal women (ages 58 to 76). FSH and LH levels began to rise in men in their 40's, and the increase became more conspicuous in the later age decades. The degree of elevation was nowhere comparable to that observed in the aging women. In the male, the serum testosterone levels showed a progressive decrease from the fifth age decade onward, whereas in the female there was an increase after the menopause. Estradiol levels showed no significant change in the aged male, but they were somewhat higher than in the aged female. Exceptions to the low-testosterone and low-gonadotropin relationship were observed in individual cases and might be explained by relatively high estradiol values. Proper replacement therapy by means of estrogens for the postmenopausal female and androgens for the aging male is often of great benefit, physically and emotionally.

Adult↗

PubMed2002

[Prevention and complementary medicine in aging].

The subsequent brief review is based on a systematic literature search (Medline, http://www.lef.org and books under the topic Antiaging from 2001). Among the preventive and complementary measures against aging, caloric restriction with an adequate diet is in first place. If the energy supply is reduced by 17%, cardiovascular mortality drops to 31-41%. Among the mechanisms of aging, impaired formation of reactive oxygen species (oxidative stress) plays an important role. Moreover, antioxidants (vitamins A and B as well as selenium) provide protection. If obesity is complicated by a metabolic syndrome, a formula diet should be employed under the supervision of the urologist. The hormonal changes involved in the male climacteric should be treated by hormone replacement therapy. Testosterone given as a gel, plaster, or injection compensates for the secondary hypogonadism and treats osteoporosis. The muscle function can be improved by physical activity only. Sexual dysfunction, however, is not corrected with androgen hormone replacement therapy, whereas an appropriate physical training program may even improve potency by inducing a reactive penile hyperemia. In his office the urologist may implement a program specifically for the "aging male." If he diagnoses a metabolic syndrome, effective countermeasures are required to prevent early onset of arteriosclerosis.

Aged↗

PubMed2000

Andropause: a misnomer for a true clinical entity.

PURPOSE: A progressive decrease in androgen production is common in males after middle age. The resulting clinical picture has been erroneously named male menopause or andropause. A more appropriate designation is androgen decline in the aging male (ADAM). The syndrome is characterized by alterations in the physical and intellectual domains that correlate with and can be corrected by manipulation of the androgen milieu. We review the epidemiological aspects of aging and endocrinological manifestations of ADAM, and provide recommendations for treatment and monitoring of these patients. MATERIALS AND METHODS: We performed MEDLINE, Pubmed, Current Contents and Pharmaceutical Abstracts searches of relevant peer reviewed publications on andropause, male climacteric, adult hypogonadism and aging. In addition, conference proceedings were researched to provide a more complete review of the literature. Information was scrutinized and collated, and contributory data were reviewed and summarized. RESULTS: ADAM is a clinical entity characterized biochemically by a decrease not only in serum androgen, but also in other hormones, such as growth hormone, melatonin and dehydroepiandrosterone. Clinical manifestations include fatigue, depression, decreased libido, erectile dysfunction, and alterations in mood and cognition. CONCLUSIONS: The onset of ADAM is unpredictable and its manifestations are subtle and variable, which has led to a paucity of interest in its diagnosis and treatment. Urological practice commonly includes a large proportion of men older than 50 years. Therefore, it is important for urologists to recognize the manifestations of and be familiar with evaluations necessary to document ADAM as well as its treatment and monitoring.

Aged↗

PubMed2003

Age-related change in serum concentrations of testosterone in middle-aged Korean men.

The objective of this study was to determine whether testosterone and sex hormone binding globulin (SHBG) levels are different between healthy men and men with chronic illness, and to evaluate the age-related changes of testosterone and SHBG in healthy men in Korea. enrollment took place between January 2000 and December 2001 at Pundang CHA General Hospital in Korea. All men who came for male climacteric and geriatric health screening examinations were eligible. Of the 762 men recruited, 136 men had at least one present or previous medical illness and 626 men were healthy. Higher serum concentrations of total testosterone (5.31 +/- 1.88 ng/ml vs. 4.96 +/- 1.43 ng/ml; p < 0.05), free androgen index (16.60 +/- 7.36 vs. 14.57 +/- 5.55; p < 0.01) and calculated bioavailable testosterone (8.88 +/- 3.52 nmol/l vs. 7.91 +/- 2.52 nmol/l; p < 0.01) were demonstrated in the healthy compared with the disease group. Total testosterone declined at a rate of 0.2% per year, SHBG increased by 1.74% per year, calculated bioavailable testosterone declined by 0.8% per year, and free androgen index declined by 1.15% per year in healthy subjects aged between 40 and 70. The above results seem to be consistent with previous Western studies, showing higher concentrations of testosterone in healthy men, that decline with increasing age.

Adult↗

PubMed1980

Fennel and anise as estrogenic agents.

Fennel, Foeniculum vulgare, and anise, Pimpinella anisum, are plants which have been used as estrogenic agents for millennia. Specifically, they have been reputed to increase milk secretion, promote menstruation, facilitate birth, alleviate the symptoms of the male climacteric, and increase libido. In the 1930s, some interest was shown in these plants in the development of synthetic estrogens. The main constituent of the essential oils of fennel and anise, anethole, has been considered to be the active estrogenic agent. However, further research suggests that the actual pharmacologically active agents are polymers of anethole, such as dianethole and photoanethole.

Allylbenzene Derivatives↗

PubMed1962