MALE MENOPAUSE - HOW TO DEFINE IT, HOW TO TREAT IT

Does male menopause exist? If the term implies a physiologic event ana logous to female menopause, that is, complete cessation of gonadal rep roductive function over a rather limited and relatively well-defined t ime span that is essentially universal by the sixth decade of life, th e answer is no. However, many symptoms often associated with female me nopause can occur in middle-aged men, even though the incidence, age a t onset, and severity are more variable. With a looser definition, the n male menopause does exist and is defined as gradual, age-related dec line in gonadal function, which by the fifth or sixth decade of life s pans a continuum from frankly hypogonadal to clearly eugonadal and whi ch may have a role in age-related changes in body composition, bone ma ss, and sexual function. The use of testosterone therapy in eugonadal elderly men to prevent or ameliorate such common conditions of aging a s decreased sexual function, diminished bone density, and loss of musc le mass has not been thoroughly researched. Currently, testosterone th erapy is indicated for hypogonadism with either decreased libido or mi ld sexual dysfunction. Routine androgen therapy in aging men should aw ait further evidence of acceptable risk-benefit profiles from clinical trials.