Turkish Journal of Geriatrics 2001 , Vol 4, Issue 4
Cenk Yücel BİLEN, Haluk ÖZEN
19 Mayıs Üniversitesi Tıp Fakültesi, Üroloji Anabilim Dalı, Samsun
Hacettepe Üniversitesi Tıp Fakültesi, Üroloji Anabilim Dalı, Ankara
In men gonadal function is affected in a slow progressive way as part of the normal aging process. Only recently, significant interest has developed on the importance of this problem with the increase in aging male population. The prevalence of ADAM is not accurately known but it can be infer from population projections that diseases associated specifically with aging will increase significantly in the 25 years. ADAM becomes evident from the age of 45-50 years on. It is evident, that some of the manifestations associated with the decline in androgen production in the aging male can also be attributed to age-associated alteration in other endocrine regulatory systems. The andropause syndrome is characterized by: 1.diminished sexual desire and erectile quality, 2. changes in mood, 3. decrease in lean body mass with associated diminution in muscle volume and strength, 4. decrease in body hair, 5. decreased bone mineral density, 6. increase in visceral fat. These manifestations need not all be present to identify the syndrome. In addition, the severity of one or more of them does not necessarily matches the severity of the others. It is recommended that in patients at risk or suspected of hypogonadism the following biochemical investigations be done: serum testesteron between 8:00 and 11:00 AM. If testesteron levels are below or at the lower limit of the accepted normal values, it is prudent to confirm the results with a second determination together with assessment of luteinizing hormone (LH), follicle stimulating hormone (FSH) and prolactin. The only contraindications for treatment are breast cancer and prostate cancer. Therefore the patients should be investigated for prostate cancer before the treatment. There are many current treatment options. Testosterone replacement therapy should maintain not only physiologic levels of serum testosterone but also the circadian rhythm. This is accomplished best by 'he dermal patches. In addition to the specific areas of interest, long-term monitoring of these patients for potential side effects is mandatory. Keywords : Andropause, Aging male, PADAM, Male climacteric, Hormonal changesety