Endocrine aspects of ageing in the male

There is a statistical decline of testosterone levels in ageing men, most m anifest in free testosterone. While this fall is only moderate, ageing men show clinical signs of hypogonadism (loss of muscle mass/strength, reductio n in bone mass and an increase in visceral fat). This might represent not o nly a fall but (also) an impairment of the biological action of androgens i n target organs. The first small scale studies of androgen supplement admin istration in ageing men were not disappointing. Anticipated risks lie with the prostate and the cardiovascular system. The risks with regard to prosta te disease are often over-rated. The question remains how the segment of th e ageing male population possibly benefiting from androgen supplements, can be identified. For the treatment of postmenopausal women 'designer oestrog ens' are being developed; similarly, designer androgens retaining beneficia l anabolic effects with elimination of harmful effects on the prostate and cardiovascular system, could be devised. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.