Serum levels of sex hormones and ageing

Introduction. The causes of many problems of ageing males, such as impotence, benign prostatic hyperplasia (BPH), cardiovascular diseases and depression, are not sufficiently understood. Are these changes age-dependent?

Patients and methods. In a clinical study, serum hormone levels of gonadotrophins such as luteinizing hormone (LH) and follicle-stimulating hormone (FSH), as well as prolactin and androgens such as testosterone (T), free testosterone (fT), dihydrotestosterone (DHT), dehydroepiandrosterone (DHEA), dehydroandrosterone sulphate (DHEA-S), androstenedione (AS) and sex hormone-binding globulin (SHBG), were analysed in 95 males. Of these, 25 were younger than 40 years old (group 1), and 70 were aged from 40 to 70 years (group 2). In group 2, 30 males suffered from erectile dysfunction (ED) and 25 from BPH, whereas 15 men had no age-dependent disease.

Results. Improved levels of different gonadotrophins (LH, FSH and prolactin) were found in only three patients of group 1, whereas gonadotrophins were improved in 12 patients (17%) of group 2. Androgens were decreased to a significantly greater extent in patients of group 2: T in 11 (16%), fT in 12 (17%), and DHT in 24 patients (34%). SHBG was increased in 19 patients (27%) of this group. Altered serum hormone levels in patients of group 2 were only found in those with ED and/or symptomatic BPH. No symptomless patient over 40 years had any changes in serum hormone levels of gonadotrophins or androgens.

Conclusion. The results demonstrate that only some men older than 40 years had decreased levels of androgens associated with clinical symptoms (impotence and lower urinary tract symptoms). Similarly to the female climacterium, ageing males also show a deficiency of sex hormones. In contrast to the female menopause, the male andropause does not occur in every elderly man. Therefore, it is better to speak of partial androgen deficiency in the ageing male (PADAM).