| 2.
Lund BC, Bever-Stille KA, Perry PJ. Testosterone and
andropause: the feasibility of testosterone replacement therapy
in elderly men. Pharmacotherapy 1999;19:951-6.
Abstract: Andropause, a syndrome in aging men, consists of
physical, sexual, and psychologic symptoms that include weakness,
fatigue, reduced muscle and bone mass, impaired hematopoiesis,
oligospermia, sexual dysfunction, depression, anxiety, irritability,
insomnia, memory impairment, and reduced cognitive function.
Free testosterone levels begin to decline at a rate of 1%
per year after age 40 years. It is estimated that 20% of men
aged 60-80 years have levels below the lower limit of normal.
Although the causal relationship between declining testosterone
levels and development of andropause symptoms is not firmly
established, administration of testosterone to this population
resulted in improvements in many areas. Most studies to date
focused on physical benefits of testosterone replacement and
failed to assess psychologic symptoms rigorously. Preliminary
data suggest that therapy may benefit elderly men with new-onset
depression. Testosterone administration is not without problems,
the most worrisome being the potential for increased prostate
cancer risk. Despite this concern, a limited number of studies
administered the hormone weekly for up to 2 years, with only
mild increases in prostate-specific antigen over control values.
Currently, insufficient evidence, primarily regarding psychologic
safety and efficacy, exists to warrant general administration
of testosterone to elderly hypogonadal men. Further clinical
investigations of this therapy in men with low testosterone
levels and andropause symptoms are justified and necessary
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