PURPOSE: Late-onset hypogonadism (LOH) in aging males is a clinical and biochemical syndrome characterized by a decline in serum testosterone levels. LOH results in various physical and mental disabilities. We evaluated the relationship between serum testosterone levels and symptoms of LOH. MATERIALS AND METHODS: During an andropause screening program, we examined responses to the Saint Louis university androgen deficiency in aging males (ADAM) questionnaire and results on the International Index of Erectile Function (IIEF-5) in terms of clinical symptoms and evaluated serum total testosterone levels for a biochemical diagnosis of LOH in healthy community-living volunteers aged over 40 years. RESULTS: The mean age of the 534 men was 59.1 years (range, 40 to 79 years), and their mean serum testosterone level was 464.1+/-171.9 ng/dL. The serum testosterone level decreased significantly with age. There was a 92.5% positive response rate to the ADAM questionnaire. The percentage of patients whose serum testosterone level was <350 ng/dL among those with a positive response to the ADAM questionnaire was 25.6% (137 patients). The mean serum testosterone level among patients with a positive or negative ADAM questionnaire was 472.4+/-198.5 ng/dL and 487.3+/-165.7 ng/dL, respectively (p>0.05). There was no significant correlation between IIEF-5 scores and serum testosterone levels. CONCLUSIONS: Among men over 40 years of age, 25.6% met the clinical and biochemical diagnostic criteria for LOH. There was no relationship between serum testosterone levels and symptoms of LOH.
Aged ; Aging ; Andropause ; Humans ; Hypogonadism ; Male ; Mass Screening ; Testosterone

PURPOSE: To evaluate the anti-apoptotic effect of the antioxidant reaction of anthocyanin on the prostate in an andropause animal model. MATERIALS AND METHODS: Sprague-Dawley rats were divided into three groups (n=12 in each): control (Group I), andropause (Group II), andropause treated with anthocyanin (Group III). For induction of andropause, Group II and III underwent bilateral orchiectomy. Group III was treated with daily oral anthocyanin (160 mg/kg) for 8 weeks. After 8 weeks, the rats were sacrificed and their blood and prostates were examined pathohistologically and evaluated for oxidative stress and apoptosis. Oxidative stress was assessed by the activity of superoxide dismutase (SOD) and apoptosis in the prostate was identified by terminal deoxyribonucleotidyl transferase-mediated dUTP-digoxigenin nick end-labelling assay. RESULTS: Group II showed markedly increased activity of SOD in serum over that observed in Group I, whereas the rats in Group III showed reduced oxidative stress compared to Group II. Despite no significant differences in prostate weight between Group II and III (p=0.078), the apoptotic index was significantly greater in Group II than Group I, and was significantly lesser in Group III than Group II. CONCLUSIONS: We suggest that the oxidative stress caused by low testosterone may be another inducer of apoptosis, and this apoptosis may partly contribute to the overall apoptosis of the prostate in the andropause animal model. Therefore, anthocyanin supplementation may contribute to preventing excessively rapid cell death by apoptosis in the prostate in an animal model of andropause.
Andropause* ; Animals* ; Anthocyanins* ; Antioxidants ; Apoptosis* ; Cell Death* ; Male ; Models, Animal* ; Orchiectomy ; Oxidative Stress ; Prostate* ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; Testosterone

OBJECTIVETo access the prevalence of menopause-like symptoms, and their related factors in old and middle-aged males in the area of Hefei.

METHODSThis study included 1 026 males aged over 45 years that came to the clinic for health examination. We collected their personal data, and evaluated their general health status and the results of the questionnaire investigation using the Aging Males' Symptoms (AMS) scale.

RESULTSThe total incidence of menopause-like symptoms was 64.7% among the old and middle-aged males in Hefei area, of which 58.1% were mild, 30.9% moderate and 11.0% severe. The average AMS score was 31.2 +/- 6.8, in which the scores on psychological, physical and sexual function symptoms were 8.3 +/- 2.1, 12.4 +/- 4.8 and 9.3 +/- 4.5, respectively. Sexual function symptoms were increased significantly with the increase of age (P < 0.05), but psychological and physical symptoms showed no obvious correlation with age (P > 0.05). The main risk factors of menopause-like symptoms included age, smoking, diabetes, cardiovascular diseases, and obesity, but physical exercise was an important protective factor against them.

CONCLUSIONWith the increase of age, the prevalence of male menopause-like symptoms rises and sexual function declines gradually, but psychological and physical scores are not affected significantly. Age, general health status and lifestyle are closely associated with the prevalence of menopause-like symptoms among old and middle-aged males.

Aged ; Aged, 80 and over ; Aging ; Andropause ; China ; epidemiology ; Humans ; Incidence ; Life Style ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Surveys and Questionnaires

Many aging male suffer various andropause symptoms including loss of physical and mental activities. This study evaluated the putative alleviative effects of CRS-10 dandelion and rooibos extract complex (CRS-10) on the symptoms of andropause. The survival rate of TM3 Leydig cells (TM3 cells) treated with CRS-10 was measured based on typical physiological stress. After daily intake of CRS-10 for 4 weeks, the level of testosterone, physical activity and both the number and activity of sperm in older rats (18 weeks) were measured. Furthermore, thirty males were surveyed with AMS (Aging Males' Symptoms) questionnaire after intake of 400 mg of CRS-10. Overall, CRS-10 protected TM3 cells from serum restriction and oxidative stress via activation of ERK and Akt pathways. The level of testosterone and activation of spermatogenesis in rats were significantly enhanced. In addition, physical locomotion was markedly improved. Daily intake of 400 mg of CRS-10 improved the quality of life among agingmale respondents, according to a clinical survey using the AMS. The results indicate the potential of CRS-10 as a safe and efficacious natural substance for reducing or alleviating andropause symptoms.
Aging ; Andropause ; Animals ; Aspalathus ; Humans ; Leydig Cells ; Locomotion ; Male ; Motor Activity ; Oxidative Stress ; Quality of Life ; Surveys and Questionnaires ; Rats ; Spermatogenesis ; Spermatozoa ; Stress, Physiological ; Survival Rate ; Taraxacum ; Testosterone

PURPOSE: We evaluated the efficacy and safety of transdermal 1% testosterone gel in Korean men with late-onset hypogonadism from Aug. 2004 to Dec. 2005 in a prospective, fixed-dose, placebo-uncontrolled, open label, multicenter study. MATERIALS AND METHODS: From the 5 urological centers in Korea, a total of 87 male patients older than 40 years who were diagnosed with late-onset hypogonadism with serum testosterone lower than 350 ng/dl or serum free testosterone lower than 73.5 pg/ml were enrolled. Among the 87 enrolled 68 patients completed the daily application of 1% testosterone gel according to the standard consumer guidelines for the full 12-week period. We compared the data at baseline and at 4, 8, and 12 weeks follow-up using the Aging Males' Symptoms (AMS) scale, the International Index of Erectile Function (IIEF)-15, the International Prostate Symptoms Score (IPSS), and the serum levels of total and free testosterone and prostate specific antigen (PSA). RESULTS: The mean age of the patients was 56.5+/-12.7 years. The total scores for the AMS scores at baseline, 4, 8, and 12 weeks were 43.5+/-12.2, 36.6+/-12.3, 33.8+/-11.2, and 34.2+/-11.0, respectively (p<0.0001 vs. baseline). Total and free testosterone levels at baseline were 259.8+/-119.4 ng/dl and 50.5+/-24.7 pg/ml, and at 12 weeks were 594.5+/-376.6 ng/dl and 139.5+/-110.7 pg/ml, respectively (p<0.0001 vs. baseline). IIEF scores increased from 34.7+/-8.5 at baseline to 43.2+/-8.7 at 12 weeks (p<0.0001). There were no significant changes in serum PSA levels. The most commonly reported adverse events were acne and itching at the site of application. The majority of adverse events were mild, reversible, and short in duration. CONCLUSIONS: Testogel(R) showed highly effective clinical and biochemical recovery with good tolerance in Korean men with late-onset hypogonadism.
Acne Vulgaris ; Aging ; Andropause ; Follow-Up Studies ; Humans ; Hypogonadism* ; Korea ; Male ; Prospective Studies* ; Prostate ; Prostate-Specific Antigen ; Pruritus ; Testosterone*

PURPOSE: Late-onset hypogonadism(LOH) in the aging male is a clinical and biochemical syndrome characterized by a decline in levels of serum testosterone, and results in various physical and mental disabilities. We aim to evaluate the relationship between serum testostosterone levels and symtpoms of LOH. MATERIALS AND METHODS: As part of an andropause screening program, we examined ADAM questionnaires, IIEF-5 scores, and total serum testosterone levels among healthy volunteers aged over 40 years. RESULTS: The mean age of the 409 men was 59.8 years(range 40~89), and the mean serum testosterone level was 471.5+/-180.2 ng/dl. The serum testosterone level decreased significantly in correlation with age. There was a 92.5% positive response on the ADAM questionnaire. Among patients whose serum testosterone was less than 350 ng/dl, the ADAM questionnaire was positive in 23.7%(n=97). The mean serum testosterone level for men with a positive or negative ADAM questionnaire was 469.2+/-181.8 or 489.2+/-170.5 ng/dl, respectively; this difference was not statistically significant (p=xxx). There was also no significant correlation between IIEF-5 scores and serum testosterone levels. CONCLUSIONS: Among men over 40 years of age, 23.7% met the clinical and biochemical diagnostic criteria for late-onset hypogonadism, and there was no relationship between serum testosterone levels and symptoms of late-onset hypogonadism.
Aging* ; Andropause ; Healthy Volunteers ; Humans ; Hypogonadism* ; Male* ; Mass Screening ; Surveys and Questionnaires ; Testosterone*

There has been a great deal of recent interests in the topic of low testosterone in elderly men, a condition referred to as andropause, ADAM (androgen decline of aging male), or PADAM (partial androgen deficiency of the aging male), or LOH (late onset hypogonadism). Age-related decreases in androgen levels occur gradually and vary considerably among individuals. A low level of testosterone has been implicated as a cause of changes in sexual, physical and behavioral capacity in aging men. Although several observational and interventional studies have demonstrated that androgens have important beneficial functions in the body composition, muscle mass and strength, fat distribution, erythropoiesis, cognition, mood and bone density, and play a key role in male sexual function, a considerable controversy exists regarding the indications of testosterone supplementation in aging male.The objective of this article is to discuss what is known and not known regarding the benefits and risks of testosterone-replacement therapy and the monitoring of men receiving testosterone treatment.
Aged ; Aging ; Androgens ; Andropause ; Body Composition ; Bone Density ; Cognition ; Erythropoiesis ; Humans ; Hypogonadism* ; Male ; Risk Assessment ; Testosterone

OBJECTIVETo 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.

METHODSForty 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.

RESULTSThe 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.

CONCLUSIONSmall 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 ; Follow-Up Studies ; Human Growth Hormone ; adverse effects ; therapeutic use ; Humans ; Insulin-Like Growth Factor I ; metabolism ; Male ; Prostate-Specific Antigen ; blood ; Sensitivity and Specificity ; Syndrome ; Testosterone ; blood

PURPOSE: Severe LUTS (lower urinary tract symptoms) have been considered to be a contraindication to ART (androgen replacement therapy) in PADAM (partial androgen deficiency in aging male) patients. But increasing numbers of patients presenting with PADAM have also LUTS due to the enlarged prostate. We investigated the effect of ART to the prostate in whom LUTS are controlled with alpha-blockers. MATERIALS AND METHODS: Of those patients who visited our clinic for PADAM symptoms and had decreased serum levels of total testosterone( <2.8 ng/ml, Biodata, Italy), men with severe voiding symptoms(IPSS 20~35) were recruited. Oral androgen(testosterone undecanoate 160 mg/day) and doxazosin(2~4 mg/day) were administered. IPSS score, prostate volume by TRUS, and serum PSA were assessed. RESULTS: A total of 25 patients were enrolled. Mean patient age was 63.5(51~89) years and median duration of follow-up was 754 days. Initial prostate volume by TRUS was 34.50+/-10.22 ml. Voiding symptoms evaluated by IPSS score improved significantly from 24.12+/-2.54 to 14.64+/-6.01(p <0.01). Serum PSA level showed no significant change from 1.20+/-0.54 ng/ml to 1.30+/-1.05 ng/ml. CONCLUSIONS: PADAM patients with severe voiding symptoms could be treated with a combination of androgen therapy and alpha-blockers. Further studies with longer follow-up would be required to confirm our results.
Aging ; Androgens ; Andropause ; Follow-Up Studies ; Hormone Replacement Therapy ; Humans ; Male ; Prostate ; Prostatic Hyperplasia ; Testosterone ; Urinary Tract

PURPOSE: This study aims to understand andropause symptoms and life satisfaction among middle-aged Korean men. METHOD: The subjects were selected among men in their middle age who visited one of two university hospitals or a convalescent center in Seoul. Korea. Eight items were used to measure their andropause symptoms. Life Satisfaction Index-Z was used to measure life satisfaction. RESULTS: Major symptoms related andropause. in the order of frequency, include memory loss, muscle weakness. powerlessness and impotence. Among the subjects. 62.5% smoked and 70% drank alcohol. and life satisfaction was generally moderate in the participants. Current smokers and alcohol drinkers reported a low level of life satisfaction. Diabetic patients and subjects who had powerlessness and hot flashes of andropause symptoms experienced a low level of life satisfaction. Muscle weakness was more frequent in current smokers, and powerlessness more in alcohol drinkers. CONCLUSION: This study's findings indicate that and ropause is one of major health concerns among middle-aged men. It reminds us of the smoking and alcohol drinking issues among middle-aged men. These findings show the necessity to improve strategies for nursing intervention in andropause symptoms and health risk behaviors.
Alcohol Drinking ; Andropause* ; Erectile Dysfunction ; Female ; Hospitals, University ; Hot Flashes ; Humans ; Korea ; Male ; Memory Disorders ; Menopause ; Middle Aged ; Muscle Weakness ; Nursing ; Risk-Taking ; Seoul ; Smoke ; Smoking