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PubMed2006

Climacteric symptoms among Japanese women and men: comparison of four symptom checklists.

OBJECTIVES: To explore whether Japanese kōnenki (climacteric) symptoms are unique to women or are experienced by men, to compare common symptom indices, and to explore the relationship between symptoms and soy intake. METHODS: Two-week recall of 54 symptoms, an eight-item food frequency questionnaire, and views about kōnenki were collected from 60 individuals in Kanazawa, Japan. Factor analysis identified kōnenki-associated symptom groupings; Blatt-Kupperman, Simplified Menopausal Index, Lock, and Kanazawa symptom scores were calculated; and sex and kōnenki status differences were tested. RESULTS: Thirty-two women and 22 men (mean age 48.7 years) provided complete questionnaires. Although males had higher prevalence of stress, irritability, and nervousness (p < 0.05), no men reported having kōnenki. Four of eight female symptom factors exhibited significant correlations with kōnenki status. All symptom index scores were lower in pre-kōnenki women than in peri-kōnenki women, but scores for men and women did not differ. Soy intake and Lock score were negatively correlated among women. CONCLUSIONS: Several symptoms commonly associated with kōnenki in Japan are not unique to women and have higher prevalence in men. Inclusion of men in climacteric studies may permit identification of male climacteric symptoms and assessment of the specificity of many typical female climacteric symptoms, thus refining and standardizing symptom checklists.

Adult↗
PubMed2004

Effect of 12 month oral testosterone on testosterone deficiency symptoms in symptomatic elderly males with low-normal gonadal status.

BACKGROUND: Relative androgen deficiency in ageing males is assumed to have adverse health effects. This study assessed the effect of 12 months' standard dose, oral testosterone, on symptoms attributed to testosterone deficiency in older men with plasma testosterone levels in the low-normal range for young men. METHODS: Testosterone undecanoate (TU, 80 mg bid) or placebo was administered for one year to 76 healthy men, 60 years or older, with a free testosterone index (FTI) of 0.3-0.5 and significant symptoms on a questionnaire designed to evaluate androgen deficiency (ADAM). The ADAM was completed at baseline, 6 and 12 months. Hormone and safety data were collected at baseline, 1, 3, 6 and 12 months. RESULTS: After 12 months, plasma total testosterone was unchanged in both groups and sex hormone binding globulin decreased in the testosterone group (P = 0.01). FTI and calculated bioavailable testosterone (cBT) were greater in the testosterone group as compared with the placebo group (P = 0.021 and 0.025, respectively). There was no significant difference in total symptom score between testosterone and placebo groups after 12 months of oral TU. However, there were trends toward improvements in sadness/grumpiness (P = 0.063), reduced erection strength (P = 0.059) and decreased work performance symptoms (P = 0.077), particularly in men with baseline cBT levels below 3.1 nmol/l. CONCLUSIONS: This study concludes that 80 mg bid oral TU does not improve overall ADAM questionnaire scores in older men with low-normal gonadal status. Oral TU may preserve mood and erectile function, as assessed by this questionnaire, particularly in men with the lowest testosterone levels.

Administration, Oral↗
PubMed2006

Correlation between the Aging Males' Symptoms Scale and sex steroids, gonadotropins, dehydroepiandrosterone sulfate, and growth hormone levels in ambulatory men.

INTRODUCTION: Partial androgen deficiency of the aging male (PADAM) is defined as a biochemical syndrome associated with advancing age that is characterized by a deficiency in serum androgen levels. The Aging Males' Symptoms (AMS) Scale was developed to evaluate PADAM-related symptoms and is currently used worldwide; however, it has been reported that PADAM-related symptoms evaluated by this scale are not related to serum testosterone levels. In addition to testosterone, the levels of other hormones also decrease with age; therefore, multihormone alterations may influence PADAM-related symptoms. AIM: To investigate the relationship between PADAM-related symptoms evaluated by the AMS Scale and serum levels of testosterone, estradiol (E2), luteinizing hormone (LH), follicle-stimulating hormone (FSH), dehydroepiandrosterone sulfate (DHEA-S), and growth hormone (GH) in men. METHODS: A total of 141 ambulatory men were recruited after excluding men with endocrine and other related diseases. All participants completed the AMS questionnaire and an analysis of serum levels of total and free testosterone (TT and FT), E2, LH, FSH, DHEA-S, and GH. MAIN OUTCOME MEASURE: The relationship between AMS scores (total and subscores) and serum hormone levels was determined. RESULTS: There were significant negative correlations between age and serum FT and DHEA-S levels, as well as positive correlations between age and serum LH and FSH levels, but no correlation between age and AMS scores. None of the three AMS domain scale scores and total scores significantly correlated with serum levels of TT, FT, E2, LH, FSH, DHEA-S, or GH. CONCLUSIONS: The results of the present study suggest that PADAM-related symptoms as evaluated by the AMS Scale are not significantly related to serum levels of TT, FT, E2, LH, FSH, DHEA-S, or GH. Because many factors related to aging are thought to contribute to the occurrence of PADAM-related symptoms, the AMS Scale may not be able to predict serum hormone levels.

Adult↗
PubMed2006

Association of specific symptoms and metabolic risks with serum testosterone in older men.

CONTEXT: Although attention and concern about health disorders in aging men have been growing, the structure of psychological and somatic complaints of actual patients, not population-based cohorts, has not been elucidated in relation to sex hormone patterns and metabolism. OBJECTIVE: The objective of the study was investigation of factors influencing complaint structures in aging male patients. DESIGN: This was a cross-sectional cohort study. SETTING: The study was conducted in an andrological outpatient department. PATIENTS: Subjects included 434 consecutive male patients aged 50-86 yr. MAIN OUTCOME MEASURES: The following hypotheses were measured: 1) psychosomatic complaints and metabolic factors in aging male patients are related to sex hormone levels in a symptom-specific manner, and 2) patients form subcohorts. RESULTS: A clear-cut threshold for late-onset hypogonadism was not found; rather, prevalence of psychosomatic symptoms and metabolic risk factors accumulated with decreasing androgen levels. For example, androgen-induced prevalence of loss of libido or vigor increased below testosterone concentrations of 15 nmol/liter (P < 0.001), whereas depression and diabetes mellitus type 2 (also in nonobese men) were significantly more present in men with testosterone concentrations below 10 nmol/liter (P < 0.001). Erectile dysfunction was identified as a composite pathology of metabolic risk factors, smoking, and depressivity, whereas only testosterone concentrations below 8 nmol/liter contributed to that symptom (P = 0.003). Cluster analysis revealed aging men to present within three independent groups characterized by psychosomatic complaints, metabolic disorders, and sexual health problems. These subgroups of patients exhibit distinct features in terms of androgen levels, age, and body mass index. CONCLUSIONS: There is no evidence that a uniform structure of testosterone concentrations and complaints exists within the cohort of elderly male patients. Rather, in aging male patients, psychosomatic complaints and metabolic risk relate to testosterone in a symptom-specific manner.

Aged↗
PubMed2004

Effects of androgen substitution on lipid profile in the adult and aging hypogonadal male.

The decrease in serum bioavailable testosterone may be responsible for the catabolic sequelae noticed in the aging man (decrease in libido, decrease in muscle mass, osteoporosis and increase in adiposity). After a brief review of androgen and lipid metabolism as well as their modifications with aging, we discuss current knowledge of the effects of androgen substitution on the lipid profile in hypogonadal men. The results of studies concerning the effect of androgen substitution therapy on lipids are conflicting but might be favorable. The small decrease in high-density lipoprotein cholesterol observed when administering standard dosages of testosterone is accompanied by a significant decrease in total cholesterol (CT) and low-density lipoprotein cholesterol. A counterbalancing of these effects plausibly accounts for the absence of increase cardiovascular risk. The currently available preparations are oral, injectable or transdermal formulations of natural testosterone. The development of new androgen preparations that are more potent, metabolically stable and tissue-specific will improve therapeutic benefits and reduce side effects.

Adult↗
PubMed2004

[Applied study on small-dose growth hormone supplement for aging-related symptom complex].

OBJECTIVE: To assess the response of aging-related symptom complex to small-dose supplement of growth hormone. METHODS: Thirty patients, aged 42 to 77, with aging-related symptom complex and normal serum testosterone were studied. Each subject received growth hormone at the dosage of 0.04 U/kg, 3 times/week for six months. Before and after treatment, body weight, grip strength, abdomen circumference, IPSS, uroflow rate, prostate volume, serum testosterone, cholesterol, triglyceride, PSA, IGF-1, glucose and side effects were determined in every case. Self Rating Scale used by Bosphorus university was adopted. RESULTS: After the treatment, the rating scores were significantly improved, grip strength and serum level of IGF-1 increased, and abdomen circumference and serum cholesterol decreased. Whereas, IPSS, uroflow rate, prostate volume, serum testosterone, triglyceride, PSA, glucose and body weight were not significantly changed. CONCLUSION: Six months treatment with small-dose growth hormone can improve aging-related symptom complex with little adverse effect.

Adult↗
PubMed2004

[Hormone therapy of ageing: myths and realities].

Is well being in the elderly be improved by hormone replacement therapy which compensate deficits accounting for generalized weakness, poor endurance, loss of muscle strength, impaired mobility and balance and decreased cognitive functions? Hormone replacement therapy of menopause has favorable effects on bone loss and decreased cognitive functions but also on several unpleasant symptoms--vasomotor instability, skin atrophy, mucosal dryness, anxiety and fatigue--but at the prize of increased incidence of cancer and cardiovascular morbidity. Decreased testosterone levels in elderly men are associated with increased fatigability, decreased muscle strength and bone mass and increased risks of accelerated atheromatosis. Testosterone substitution seems to be helpful but with side effects, particularly development of prostate cancer. Aging also affects adrenal function. The consequences of decreased DHEA production are still matter of debate. DHEA administration in elderly women seems to be associated with favorable effects on physical and psychological well being. Somatopause is characterized by a progressive decrease of growth hormone production starting as soon as the third decade. Growth hormone therapy has favorable effects on lean body mass, skin atrophy as well on body fat reduction. However, numerous side effects and the theoretical increased risk of cancer limit the use of growth hormone therapy in the elderly.

Adrenal Glands↗
PubMed2004

[Influence of androgens on the somatotrope axis: role in the therapy of postandropause osteoporosis?].

Androgens, via aromatization in estrogens, stimulate growth hormone secretion. Their influence on IGF1 (insulin-like growth factor 1, or somatomedin C) are not so clear. Some studies have observed an increase of IGF1 with testosterone therapy and some other not. The way of administration, per os or transdermic, may have an influence, like the hormonal substitutive therapy of postmenopausal women. Oral estrogen therapy decreases IGF1 levels in postmenopausal women and increases GH secretion. IG1 level is variably reduced, unaffected or increased by transdermal estrogen. High dose transdermal estrogen did not affect basal level of IGF1, but reduced the response of IGF1 to GH stimulation. Low dose transdermal estrogen did not alter either baseline or peak IGF1 level.

Androgens↗
PubMed2005

[Clinical study of recombinant human growth hormone for male climacteric syndrome].

OBJECTIVE: To evaluate the effect and safety of the recombinant human growth hormone (rhGH) in the treatment of male climacteric syndrome and to investigate the specificity and sensitivity of insulin-like growth factor-1 (IGF-1) and serum total testosterone as the curative effect index. METHODS: Forty patients aged 40-75 with male climacteric syndrome were divided into two groups randomly and injected with rhGH 4 IU (Group A) or 8 IU (Group B). The patients were followed up for about 12 weeks after 12-week treatment and then asked the questions of the assessed index of male climacteric syndrome at the 4th, 8th and 12th week of the treatment and 12 weeks after the treatment. The serum IGF-1, total testosterone (TT) and prostatic specific antigen(PSA) were measured before and after the treatment. The data were analysed by the software of SPSS 12.0 for Windows. RESULTS: The scores of the 4th, 8th and 12th week and the follow-up significantly declined compared with the baseline (P < 0.01), but did not differ significantly between Groups A and B (P > 0.05). After the treatment, serum total testosterone, PSA and prostate volume had no obvious change (P > 0.05), and the IGF-1 level was markedly higher than the baseline and the normal public. No obvious side effect was found during the treatment and follow-up. CONCLUSION: Small dosage of rhGH(4 IU/week) for 12 weeks can effectively treat male climacteric syndrome. The value of IGF-1 was parallel with the treatment effects. Short-time and small-dosage treatment with rhGH is safe and has little side effect.

Andropause↗
PubMed2005

The pathway of partial androgen deficiency of aging male.

The well documented age-related decline in serum testosterone (T) in men as the basis of the partial androgen deficiency of aging male (PADAM) syndrome is a typical multifactorial phenomenon. Aging per se can reduce T secretion through several different mechanisms, such as a primary impairment of the testes, the pituitary gland and the neurohypothalamic component, and age-associated changes in peripheral steroid metabolism. Together, these factors define the so called "idiopathic pathway". Generally, the decline in T is exacerbated by many other age-associated clinical conditions that can interfere with T metabolism: these represent the "secondary pathway". Most people experience a PADAM syndrome in which idiopathic and secondary components are simultaneously present. The different multifactorial pathway mechanisms are reviewed in this paper.

Adult↗
PubMed2005

Aging Males' Symptoms scale: a standardized instrument for the practice.

The Aging Males' Symptoms (AMS) scale was designed and standardized as self-administered scale (a) to assess symptoms of aging (independent from those which are disease-related) among groups of males under different conditions, (b) to evaluate the severity of symptoms over time, and (c) to measure changes pre- and post-androgen replacement therapy. It is a short and easy to apply instrument, it has a very simple evaluation scheme, and was internationally well accepted (translated into over 20 languages). Methodological test characteristics are: a) reliability measures: (internal consistency and test-retest stability) were found to be good across countries, b) validity: the internal structure of the AMS in healthy and androgen deficient males and across countries was sufficiently similar to conclude that the scale really measures the same phenomenon across all age groups. The comparison of the AMS with the two established screening instruments for androgen deficiency showed sufficiently good compatibility. Consequently, a screening tool for hypogonadism was developed, consisting of the AMS scale, body mass index (BMI) and age. The test characteristics of this screening tool (sensitivity and specificity) are promising. Clinicians often consider validity as utility for outcome measurement. The AMS scale showed a convincing ability to measure treatment effects on quality of life across the full range of severity of complaints before therapy. The distribution of complaints of testosterone deficient men before therapy almost returned to normal values after 12 weeks of testosterone treatment.

Adult↗
PubMed2005

The PADAM syndrome and its clinical manifestations: the muscle mass.

Many animal and in vitro studies suggest that testosterone can affect body composition. Therefore, the age-related decline in testosterone (T) likely contributes to the concomitant decrease in lean mass documented in men. While observational data in humans are not conclusive, intervention studies suggest that aged men could benefit from T replacement in term of muscle mass preservation. However, its potential positive impact on strength and functional status is unproven.

Aged↗
PubMed2005

Partial androgen deficiency and neuropsychiatric symptoms in aging men.

The partial androgen deficiency of aging males (PADAM) is responsible for a variety of behavioral symptoms, such as weakness, fatigue, decreased libido, depressive mood, lack of motivation and energy, lower psychological vitality, anxiety, irritability, insomnia, decreased work and sport performances, difficulty in concentrating, memory impairment and low dominance. Psychological and behavioral aspects of PADAM overlap with signs and symptoms of major depression. The evidence of the association between testosterone (T) level and male depression comes from studies that have assessed: 1) depression in hypogonadal subjects; 2) the relationship between T level and male depressive illness, and 3) the antidepressant action of androgen replacement. In humans, the role of androgens has been described, albeit inconsistently, in the regulation of sexuality, aggression, emotion and personality. These direct effects appear to be greatly influenced by social factors as well. Sex hormones are important for the development and maintenance of acquired cognitive abilities. Hormonal changes in androgen levels in older men modulate, at least in part, the cognitive changes of aging. Treatment with androgen hormones in hypogonadal men has shown an improvement in cognitive, verbal and visual memory, mental status, visuomotor scanning and attention, verbal knowledge/language, spatial abilities and memory for both verbal and visual information. The etiology of the behavioral symptoms of PADAM is multifactorial, being the result of the interaction of biological and social changes, and of the personal ability to adapt to the numerous individual and social changes that take place during mid-life transition.

Aged↗