Androgen deficiency and its management in elderly men

Among the many processes of aging, endocrine changes are relatively easy to identify and quantify with the presently available methods for determining hormone levels, which are reliable and sensitive. The question has been raised whether there exists a counterpart to aging in women (unfortunately labeled as menopause) in the male. It has become clear that levels of testosterone do indeed show an age-related decline but the characteristics of this age-related decline of testosterone are so fundamentally different from the menopause that drawing parallels generates more confusion than clarity. In men testosterone production is affected in a slowly progressive way as part of the normal aging process. It will rarely be manifest in men under the age of 50 years and becomes usually only quantitatively significant in men over 60 years of age. This age-related decline of testosterone shows considerable interindividual variation. Some men in their eighties will still have normal testosterone levels. Unlike the menopause, the age-associated decline of testosterone does not present itself in an 'all or none' fashion. The majority of women are able to retrospectively identify their age of menopause. Men are unable to pinpoint the start of their decline of testosterone.