Presentation on theme: "Androgens in the Aging Male The RxFiles May-June 2003 What the world needs is a little more testosterone!"— Presentation transcript:
Androgens in the Aging Male The RxFiles May-June 2003 What the world needs is a little more testosterone!
Hormones and Aging Females – sudden drop Males –gradual decline
Androgen Deficiency Symptoms Do you have a decrease in libido (sex drive)? * Do you have a lack of energy? Do you have a decrease in strength and/or endurance? Have you lost height? Have you noticed a decreased "enjoyment of life?" Are you sad and/or grumpy? Are your erections less strong? * Have you noticed a recent deterioration in your ability to play sports? Are you falling asleep after dinner? Has there been a recent deterioration in your work performance? ADAM or Morley Questionaire ???
Morley Questionnaire 10 questions every middle aged man is afraid to ask 88% sensitivity for low BT –catches most 60% specificity for low BT –catches many (~40%) who should not be caught multifactorial nature of symptoms natural course of aging other medical conditions
Testosterone by System Brain –libido, depression, irritable, concentration Body –abdominal obesity, muscle & strength, hair regression, BMD, gynecomastia Genitourinary –smaller, softer, impotence General –fatigue, energy
SHBG = sex hormone binding globulin tightly BINDS Testosterone making it unavailable Total T = free T (unbound T) + bound T ~6-28 nmol/L; AGE adjusted norms?: 40-59y =12.1-30; >60=6.9-25 Bioavailable T = free T + T bound weakly to albumin Free Androgen Index 15-95 U Testosterone (T) Levels