Andropause and the Aging Male

For many years andropause has been compared to female climaterium. Data show that symptoms are more an identification process with the climateric partner. Sexual function decreases with age but hormonal changes are not the major determining factor in this decline. There is histological evidence of an aging testicle, with reduced number of Leydig and Sertoli cells. Testosterone also declines about a third, as do dehydroepiandrosterone, dehydroepiandrosterone sulfate, prolactin, growth hormone, and insulin growth factor-1. There is no change in dehydrotestosterone and estrogens and there is an increase in follicle stimulating and luteinizing hormones levels. Recent data cannot recommend the use of hormone replacement therapy with androgens because of potential severe side effects and lack of data on long-term effects.