摘要
Owing to the demographic development, the aging male will require more consideration in future. In contrast to arapid decline of estradiol during menopause in women, the process of aging in the male is retarded and subject to highindividual variations. Impairment of spermatogenesis is observed as a continuous process occurring over decades. How-ever, only about 50% of men in their eighties show complete loss of fertility. In principle, spermatogenesis may be re-tained well into senescence. Of importance for the individual health condition is the fact that the number of Leydig cellsdeclines with advancing age. Thus, altered sex hormone concentrations in aging men result from both functional distur-bances and a gradual reduction in Leydig cells. Furthermore, an impaired feed-back mechanism of the pituitary-gonadalaxis occurs, with disappearance of the circadian testosterone (T) rhythm. LH and FSH levels are increased, and a re-duced bioavailability of sex hormones is observed. Lower total testosterone concentrations in men over 60 years are ac-companied by clinical signs of reduced virility, such as decreased muscle mass and strength as well as reduced sexualhair growth and libido. An age-related decline in androgen secretion and plasma testosterone levels therefore suggeststhe use of androgen supplementation. However, there is a lack of risk-benefit long-term studies. Increased research inthe male is mandatory to meet the requirements of the aging population. This should include the availability of preciseepidemiological data about the frequency of partial androgen deficiency in aging males (PADAM).(Asian J Androl 2001 Mar; 3: 1-7)
Owing to the demographic development, the aging male will require more consideration in future. In contrast to arapid decline of estradiol during menopause in women, the process of aging in the male is retarded and subject to highindividual variations. Impairment of spermatogenesis is observed as a continuous process occurring over decades. How-ever, only about 50% of men in their eighties show complete loss of fertility. In principle, spermatogenesis may be re-tained well into senescence. Of importance for the individual health condition is the fact that the number of Leydig cellsdeclines with advancing age. Thus, altered sex hormone concentrations in aging men result from both functional distur-bances and a gradual reduction in Leydig cells. Furthermore, an impaired feed-back mechanism of the pituitary-gonadalaxis occurs, with disappearance of the circadian testosterone (T) rhythm. LH and FSH levels are increased, and a re-duced bioavailability of sex hormones is observed. Lower total testosterone concentrations in men over 60 years are ac-companied by clinical signs of reduced virility, such as decreased muscle mass and strength as well as reduced sexualhair growth and libido. An age-related decline in androgen secretion and plasma testosterone levels therefore suggeststhe use of androgen supplementation. However, there is a lack of risk-benefit long-term studies. Increased research inthe male is mandatory to meet the requirements of the aging population. This should include the availability of preciseepidemiological data about the frequency of partial androgen deficiency in aging males (PADAM).(Asian J Androl 2001 Mar; 3: 1-7)
