Malignancy Hormone Deficiency in Aging Male

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Malignancy Hormone Deficiency in Aging Male

What is Andropause?

In men, there is a change in hormone levels in women as in menopause. 45- The hormones of the same structure, which are secreted from the adrenal gland along with the male hormone testosterone, show a steady decline. This condition, called Andropause, causes a decrease in sexual desire and mental functions as well as the decline of sexual function.

Andropause is not a very accurate definition despite its widespread use. Although the reproductive characteristics of menopause in women are complete and acute, the reproductive capacity in males may continue despite progressive age. In this context, ’androgen deficiency in aging men lanan is a more accurate definition than andropause.

What Are The Symptoms of Androgen Deficiency?

Since the average life expectancy is prolonged, physical and mental changes in the age of men are changing into a clinical picture with the decrease of androgen hormones. This clinical picture contains the following symptoms:

  • Reduction of sexual function and libido (sexual desire), especially in the quality of morning erections, drop in sperm quality
  • Reduction in intellectual capacity, loss of concentration, fatigue, anger and depression,
  • Significant reduction in muscle mass and strength,
  • Reduction in bone mineral density (osteoporosis),
  • An overall increase in body fat and weight.

In What Age is Male Hormone Deficiency Seen?

The total amount of testosterone decreases with aging, and this reduction is at the level of 0.4-1% after 50 years of age.

Depending on this decrease, biochemical hypogonadism is seen in 7% of patients under 60 years of age and this rate increases to over 20% in the age of 60 years.

The actual change is due to a 1.2% increase in the amount of sex hormone binding protein and a 1.2% decrease in the amount of bioavailable testosterone.

Therefore, the amount of free testosterone will be more accurate. Based on bioavailable testosterone levels for hypogonadism, the rate of biochemical hypogonadism over 60 years reaches 70%.

What Are The Causes of Male Hormone Deficiency?

Of course. Regardless of age, genetic disorders, obesity, various hormonal imbalances (growth hormone, thyroid hormones, insulin), alcohol, stress, and chronic diseases can also cause a decrease in testosterone levels in the blood.

Where is The Male Hormone Produced?

90% of androgens are from the testicles, 10% are from the adrenal glands and 5 different hormones in the steroid structure which have different biological effects in the body. These include testosterone, dihydrotestosterone, androstenedione, DHEA and DHEA-S.

What are The Effects of Male Hormone?

The effects of androgens begin in the mother’s womb and provide for the development of the child’s external genitalia. The effects of male reproductive system and secondary sex characters are known as androgenic effects. They act in organs such as muscle, bone, nervous system, prostate, bone marrow and have positive effects on bone and muscle strength.

On the other hand, they play a role in the development of cognitive functions throughout life. It increases the formation of nitrogen and muscle and bone formation in the body. In addition, the effects of these hormones on the production of blood cells and serum lipid levels have also been proven. These effects on growth and organs are defined as anabolic (enlarging) effects.

Does The Male Hormone Have to do With The Quality of Sexual Intercourse?

The role of androgens in erection (erectile function of the penis) is not strictly limited. Serum androgen levels above a certain value are assumed to be sufficient for normal sexual function.

However, there are conflicting opinions about this threshold. In humans, this level is almost always associated with reduced libido (sexual desire) and a decrease in the hardness and frequency of especially nocturnal erections.

Erection is caused by increased blood flow to the penis, decreasing blood flow and increasing intracranial pressure. The effects of androgens on the blood circulation of the penis, increased blood flow and decreased blood flow in the form of decreasing.

Experimental studies have shown that androgens regulate the secretion of agents involved in the erection by stimulating the hormones at the level of the hypothalamus in the brain. In addition, the presence of androgen receptors in the spinal cord is shown.

The stimulation of androgen receptors is also directly effective in the synthesis of nitric oxide, which is primarily involved in the erection. In conclusion, experimental studies have shown that androgens play a decisive role in every stage of erection.

Is There any Treatment of Male Hormone Deficiency?

Treatment possibilities for Andropause complaints have increased with technological advances, and the goals of medication treatment for androgen deprivation; replacement of sexual functions, libido (sexual desire) restoration and the provision of well-being in individuals.

Apart from these, androgen replacement therapy prevents the progression of advanced osteoporosis. It increases muscle strength and increases mental capacity. Testosterone therapy includes optimization of testosterone metabolism products, DHT and estradiol, as well as maintaining physiological serum testosterone levels in the blood.

Is There a Difference Between Treatment Modalities?

All these methods have different advantages and disadvantages. Even so, patches and testosterone gels affixed to the skin provide effective recovery. In addition, many treatment methods are still under investigation.

What Should be Considered When Treating Male Hormone Deficiency?

The aim of androgen replacement therapy is to keep testosterone levels within normal physiological limits. Supraphysiological levels should be avoided.

Whatever form of testosterone is used, liver function control is recommended at the start of treatment as well as at the start of treatment. And annual monitoring of liver function is recommended every 3 months and in the following years.

During treatment may develop polycythemia (excessive blood production). Hematologic evaluation should be performed periodically. Dose adjustment may be required. It should not be given in patients with severe sleep apnea and severe bladder outlet obstruction.

In patients over the age of 40 years, rectal examination and PSA measurement by finger is required before starting treatment. After the treatment, these evaluations should be repeated every 3 months in the first year and in the following period.

The patient should be referred to a transrectal ultrasound-guided prostate biopsy if a rectal examination or PSA measurement is encountered. In patients with suspected prostate cancer or breast cancer, androgen replacement therapy should not be given.


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