Male menopause.
Menopause is the cessation of menses caused by the age-associated decline in gonadal hormone secretion in women. Although men do not menstruate, they do have an age-associated decline in gonadal hormone secretion. This "male menopause" is associated with loss of libido, loss of muscle mass and various other undesirable effects. The underlying causes of decreased testosterone production in older men may include decreased hypothalamic gonadotropin releasing hormone (GnRH) secretion, impaired feedforward effect of luteinizing hormone (LH) on testosterone secretion and decreased testosterone release from the Leydig cells. When chronic illness is superimposed on healthy aging, there are further decrements in testosterone availability. Although a consensus has not been reached, various studies suggest that older men may benefit from testosterone supplementation. For example, testosterone supplementation to older men seems to cause increased muscle protein synthesis, increased muscle strength and decreased cholesterol. Nevertheless, if testosterone supplementation is provided, clinicians must be vigilant to detect adverse effects such as accelerated growth of prostate carcinoma.
Mulligan
T
T
Section of Geriatrics Medicine and Division of General Medicine, Hunter Holmes McGuire VA Medical Center and Medical College of Virginia/Virginia Commonwealth University, Richmond, Virginia 23249, USA.
Godschalk
M
M