Abstract
This chapter presents an overview of the potential effects of testosterone (T) deficiency in aging men. Symptoms of T deficiency are similar to many of those associated with aging. They include loss of stamina, depressed mood, decreased libido, erectile dysfunction, decreased muscle mass and strength, increased fat mass, frailty, osteopenia, and osteoporosis. Age-related changes in total T underestimate changes in T available to target tissues. An increase of sex hormone binding globulin (SHBG) with aging and a decrease in T and free T (fT) levels are independent of changes in body mass index. The decline in T levels with aging when associated with symptoms and signs of androgen deficiency has been called andropause. This association also has been referred to as androgen deficiency in the aging male (ADAM), partial androgen deficiency in the aging male (PADAM), aging-associated androgen deficiency (AAAD), or late-onset hypogonadism. Cognitive function decreases with aging. Most of the age-related changes in cognition are associated with vascular and/or degenerative diseases that cause anatomic changes in the central nervous system.
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