HORMONAL SUBSTITUTION IN OLDER MEN

The biological bases of endocrine alterations in ageing men are now we ll identified: progressive impairment of testicular function, decline in growth hormone (GH) secretion with decreased insulin-like growth fa ctor-I (IGF-T) levels, and reduced adrenal androgen secretion. Insulin resistance and glucose intolerance also accompany male ageing. The me chanisms of these age-related changes are still unknown. There are pre liminary results on the effects of hormonal replacement therapy in old er males with mild hypogonadism or decreased IGF-I levels. Controlled placebo studies will in the future define the risks and benefits of lo ng-term administration of androgens, GH or GH-releasing hormone in the se patients. In view of the severe potential side effects, the general ized use of hormonal substitution in elderly men cannot, for the momen t, be recommended.