Partielle endokrine defizienz des alternden mannes (PEDAM)

Despite the enormous medical progress during the past few decades, the last years of life are still accompanied by increasing ill health and disability. The ability to maintain independent living for as long as possible is a crucial factor of health and aging. Therefore the promotion of healthy aging and the prevention of disability in all older people must assume a central role in medical research and medical practice as well as in the formulation of national health and social policies. Effective programs promoting health and aging will ensure a more efficient use of health and social services and improve the quality of life in older persons by enabling them to remain independent and productive. The most important and drastic gender differences in aging are related to the reproductive organs. In distinction to the course of reproductive aging in women, with the rapid decline in sex hormones and expressed by the cessation of menses, aging men experience a slow and continuous decline of hormones. This decline in endocrine functions involves: decrease of testosterone, dehydroepiandrosterone (DHEA), thyroid stimulation hormone (TSH), growth hormone (GH), IGF-1 and melatonin. This decrease is concomittant with an increase of LH and FSH. In addition sex hormone binding globulins (SHBG) increase with age, resulting in further lowering the concentrations of free biologically active androgens. Interventions such as hormone replacement therapy may alleviate the debilitating conditions of secondary partial endocrine deficiencies by preventing the preventable and delaying the inevitable. Evidence is available that such intervention may slow the progress of disease in women. There is an urgent need to obtain such information for men. In light of this, public awareness of medical knowledge needs to be increased and basic, clinical, socio-economic and epidemiological research intensified. This will necessitate a quantum leap in multi-disciplinary and internationally coordinated research efforts. Such effort should be supported by the establishment of new partners between inter-governmental, governmental, commercial and voluntary sectors.