The male climacterium: Clinical signs and symptoms of a changing endocrineenvironment

Frailty is characterized by generalized weakness, impaired mobility and bal ance, and poor endurance. Loss of muscle strength is an important factor in the process of frailty, and is the Limiting factor for an individual's cha nces of Living an indepedent life until death. Ln men, several hormonal sys tems show a decline in activity during aging. Serum bioavailable testostero ne (T) and estradiol (E2), dehydroepiandrosterone (DHEA) and its sulfate (D HEAS), and growth hormone (GH) and insulin-like growth factor (IGF)-I conce ntrations all decrease during aging in men. Physical changes during aging h ave been considered physiologic, but there is evidence that some of these c hanges are related to this decline in hormonal activity. In a cross-section al study performed among 403 independently living elderly men, positive ind ependent associations were observed between serum bioavailable T and muscle strength and bone mineral density (BMD). Serum T was negatively associated with fat mass. Serum luteinizing hormone (LH) increased with age and was i nversely associated with T. Independent of T, LH was negatively related wit h muscle strength and positively with the number of problems in activities of daily Living. Further, a positive relation was present between serum E2 and BMD. A positive association between DHEAS and BMD was dependent on T an d E2 concentrations. Finally, in the same study, men with the highest E2 co ncentrations were significantly more satisfied with Life, measured with a q uestionnaire developed by Herschbach and Huber, compared to men with the lo west E2 concentrations. In conclusion, these findings are in agreement with other studies, which suggest that the maintenance of a good physical funct ional ability and quality of life is related to serum T, E2, and DHEA(S) co ncentrations. Prostate Supplement 10:2-8, 2000. (C) 2000 Wiley-Liss, Inc.