Aging in men is accompanied by a progressive, but individually variable decline of serum testosterone production, more than 20% of healthy men over 60 yr of age presenting with serum levels below the range for young men. Albeit the clinical picture of aging in men is reminiscent of that of hypogonadism in young men and decreased testosterone production appears to play a role in part of these clinical changes in at least some elderly men, the clinical relevancy of the age-related decline in sex steroid levels in men has not been unequivocally established. In fact, minimal androgen requirements for elderly men remain poorly defined and are likely to vary between individuals. Consequently, borderline androgen deficiency cannot be reliably diagnosed in the elderly, and strict differentiation between “substitutive” and “pharmacological” androgen administration is not possible. To date, only a few hundred elderly men have received androgen therapy in the setting of a randomized, controlled study, and many of th...

https://www.hormonebalance.org/images/documents/Kauffman%2005%20TDS%20REVIEW%20ER.pdf

The decline of androgen levels in elderly men and its clinical and therapeutic implications.

Preface 1. The medical and cultural history of testosterone and the testes Eberhard Nieschlag and Susan Nieschlag 2. Testosterone: biosynthesis, transport, metabolism and (non-genomic) actions C. Marc Luetjens and Gerhard F. Weinbauer 3. Pathophysiology of the androgen receptor Olaf Hiort, R. Werner and Michael Zitzmann 4. Methodology for measuring testosterone, DHT and SHBG in a clinical setting Manuela Simoni, Flaminia Fanelli, Laura Roli and Uberto Pagotto 5. The behavioral correlates of testosterone John Bancroft 6. The role of testosterone in spermatogenesis Liza O'Donnell and Robert I. McLachlan 7. Androgens and hair: a biological paradox with clinical consequences Valerie Anne Randall 8. Testosterone and bone Dirk Vanderschueren, Mieke Sinnesael, E. Gielen, F. Claessens and S. Boonen 9. Androgens effects on the skeletal muscle Shalender Bhasin, Ravi Jasuja, Carlo Serra, Rajan Singh, Thomas W. Storer, Wen Guo, Thomas G. Travison and Shezad Basaria 10. Testosterone and cardiovascular disease Kevin S. Channer and T. Hugh Jones 11. Testosterone, obesity, diabetes and the metabolic syndrome T. Hugh Jones and Kevin S. Channer 12. Testosterone and erection Mario Maggi and Hermann M. Behre 13. Testosterone and the prostate John T. Isaacs and Samuel R. Denmeade 14. Clinical use of testosterone in hypogonadism and other conditions Eberhard Nieschlag and Hermann M. Behre 15. Testosterone preparations for clinical use in males Hermann M. Behre and Eberhard Nieschlag 16. Androgens in male senescence Jean-Marc Kaufman, Guy T'Sojen and Alex Verleulen 17. Androgen therapy in non-gonadal disease David J. Handelsman 18. Review of guidelines on diagnosis and treatment of testosterone deficiency Ronald S. Swerdloff and Christina C. L. Wang 19. Pathophysiology of estrogen action in men Vincenzo Rochira, Daniele Santi and Cesare Carani 20. Dehydroepiandrosterone (DHEA) and androstenedione Bruno Allolio, Wiebke Arlt and Stefanie Hahner 21. The state-of-the-art in the development of selective androgen receptor modulators (SARMs) Ravi Jasuja, M. Zacharov and Shalender Bhasin 22. The essential role of testosterone in hormonal male contraception Eberhard Nieschlag and Hermann M. Behre 23. Testosterone use in women Susan R. Davis 24. Detection of illegal use of androgens and SARMs Wilhelm Schanzer and Mario Thevis 25. Clinical effects of doping with anabolic steroids Elena Vorona and Eberhard Nieschlag Index.

Testosterone : action, deficiency, substitution

Objective: This article defines androgens (and anabolic steroids), describes their mechanisms of action, and summarizes their behavioral effects and relevance in animals and humans. Method: A MEDLINE-derived review of the literature on androgens and behavior was perIormed; pivotal earlier publications were also obtained and included in the review. Results: In animals, the effects of androgens on brain structure and function are well-established and profound, with behavioral implications extending far beyond reproduction. Androgens play a prominent role in the organization or programming ofbrain circuits, which are subsequently activated by gonadal steroids. In humans, roles for androgens have been described, albeit inconsistently, in the regulation ofsexuality, aggression, cognition, emotion, and personality. The relevance of androgens for psychiatry is further suggested by gender-related differences in pharmacokinetics/pharmacodynamics and in the prevalence, course, and treatment response characteristics ofseveral psychiatric disorders. Direct psychoactive effects ofexogenously administered androgens have been described for many years, most recently in reports of the psychotoxic effects of anabolic steroids. Conclusions: Data from both animals and humans suggest that the biological and behavioral responses to androgens are context-dependent. (Am J Psychiatry 1996; 153:974-984)

http://www.gruberpeplab.com/teaching/psych3131_spring2015/documents/8.1_RubinowSchmidt1996.pdf

Androgens, Brain, and Behavior

Ernst Laqueur

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