Declining gonadal function in elderly men

doi:10.1016/S0950-351X(97)80302-3

Baillière's Clinical Endocrinology and Metabolism

Volume 11, Issue 2, July 1997, Pages 289-309

https://doi.org/10.1016/S0950-351X(97)80302-3 Get rights and content

Ageing in men is accompanied by a progressive decline of gonadal function with, in particular, a decline of total and free testosterone (T) plasma levels resulting in a significant proportion of elderly men over age 60 years presenting with subnormal T levels compared with the levels in young adults. A great interindividual variation in T levels is observed in elderly men, a variability explained in part by physiological variables and differences in life style, while associated acute or chronic diseases may accentuate the age-related decline of T levels. The progressive decrease of plasma T levels has been shown to result from both primary testicular changes and altered neuroendocrine regulation of Leydig cell function. At present, little is known about the clinical relevance of the relative hypoandrogenism of elderly men and there is an urgent need for more longitudinal studies, which may clarify a possible role of decreased T levels in the modulation of the clinical consequences of ageing in men. In view of the lack of relevant controlled clinical trials having careful assessment of the risks and benefits of androgen replacement therapy in elderly men, this treatment should be reserved for selected patients with clinically and biochemically manifest hypogonadism, after careful screening for contraindications.

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The anabolic effect of T is reduced during aging because of a gradual and consistent decline in circulating T that begins around the third to fourth decade of life in men,28,29 also known as andropause. Approximately 40% to 50% of men over the age of 80 have T levels below that of normal healthy young individuals.28,30 By the third decade, both men and premenopausal women experience a decline in DHEA and DHEA-S,31 which can serve as precursors for the production of androgenic hormones such as T.32 The decline in total and free T levels in men occurs at a rate of approximately 1% and 2% per year, respectively (Figure 1A).33,34
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Declining gonadal function in elderly men

Journal of Steroid Biochemistry

Journal of Steroid Biochemistry

American Journal of Medicine

Metabolism

Endocrinology and Metabolism Clinics of North America

Drug and Alcohol Dependence

American Journal of the Medical Sciences

Fertility and Sterlity

Journal of Steroid Biochemistry and Molecular Biology

Metabolism

Metabolism

Journal of Bone and Mineral Research

Journal of Steroid Biochemistry

Western diet and Western diseases: some hormonal and biochemical mechanisms and associations

Scandinavian Journal of Clinical and Laboratory Investigation

Testosterone concentration in women and men with NIDDM

Diabetes Care

A study of the endocrine manifestations of hepatic cirrhosis

Quarterly Journal of Medicine

Endogenous sex hormone levels and cardiovascular disease in men: a prospective population based study

Circulation

Endogenous sex hormone levels in older men with diabetes mellitus

American Journal of Epidemiology

Emerging issues in androgen replacement therapy

Journal of Clinical Endocrinology and Metabolism

Adaptation to chronic stress in military trainees: adrenal androgens, testosterone, glucocorticoids, IGF-1 and immune function

Annals of the New York Academy of Sciences

Inverse effects of thioridazine (Mellaril) on serum prolactin and testosterone concentrations in normal men

Loss of circadian rhythmicity in blood testosterone levels with aging in normal men

Journal of Clinical Endocrinology and Metabolism

Slowing of pulsatile luteinizing hormone secretion in men after forty eight hours of fasting

Journal of Clinical Endocrinology and Metabolism

Prolactin-secreting tumors and hypogonadism in 22 men

New England Journal of Medicine

Usefulness of sex steroid hormone levels in predicting coronary artery disease in men

American Journal of Cardiology

Hormonal changes in elderly men with non-insulin-dependent diabetes mellitus and the hormonal relationships to abdominal adiposity

Gerontology

Alcohol induced defects in the hypothalamo-pituitary luteinizing hormone action in the male

Alcoholism

Effects of multiple ejaculations after extended periods of sexual abstinence on total motile and normal sperm numbers as well as on accessory gland secretions from healthy normal and oligospermic men

Human Reproduction

Changes in the hypothalamo-pituitary-gonadal axis in human immunodeficiency virus-infected homosexual men

Journal of Clinical Endocrinology and Metabolism

Testosterone replacement with transdermal therapeutic systems

Journal of the American Medical Association

Age and seasonal variation in serum testosterone concentration among men

Chronobiology International

Cigarette smoking and serum sex hormones in men

American Journal of Epidemiology

An inverse correlation between body weight and the activity of the steroid binding globulin in human plasma

Steroidologia

Leydig cell function in normal men

Effect of age, life style, residence, diet and activity

Journal of Clinical Endocrinology and Metabolism

Influence of age on pulsatile luteinizing hormone release and responsiveness of the gonadotrophs to sex hormone feedback in men

Journal of Clinical Endocrinology and Metabolism

Circulating inhibin and testosterone levels in men with critical illness

Clinical Endocrinology

Anomalies de l'affinité de liaison de la testostérone dans le sérum de sujets thyréotoxicosiques

Annales d'Endocrinologie

Testosterone metabolism in normal males and male cirrhotics

Zeitschrift für Gastroenterologie

Serum levels of insulin like growth factor 1 and insulin like growth factor binding protein 1 correlate with serum free testosterone and sex hormone binding globulin in healthy young and middle aged men

Clinical Endocrinology

Bone Gla protein and sex hormone-binding globulin in nontoxic goiter: parameters for metabolic status at the tissue level

Journal of Clinical Endrocrinology and Metabolism

The relation of smoking, age, relative weight and dietary intake to serum adrenal steroids, sex hormones and sex hormone binding globulin in middle age men

Journal of Clinical Endocrinology and Metabolism

Osteoporosis and decline of gonadal function in the elderly male

Hormone Research

Relation of serum testosterone levels to high density lipoprotein cholesterol and other characteristics in men

Atherosclerosis and Thrombosis

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British Journal of Rheumatology

Sex hormones and DHEA-SO₄ in relation to ischemic heart disease in diabetic subjects: the WESDR study