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Androgen Deficiency in the Aging Male

Enhancing Erectile Response to Oral Pharmacotherapy

  • Chapter
Oral Pharmacotherapy for Male Sexual Dysfunction

Part of the book series: Current Clinical Urology ((CCU))

Abstract

A rekindling of interest in androgen supplementation therapy has occurred in the last decade. Undoubtedly this is a result of the increasing recognition and acceptance of issues of men’s health, which in many ways are closely related to the aging process. This interest has not been limited to health care professionals and the pharmaceutical industry but has extensively included the lay press and the general public. In addition, long-established concepts related to hormone replacement therapy in women have been vigorously challenged, and some of the new findings were, erroneously and baselessly, extrapolated to androgen replacement therapy (ART) in men.

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References

  1. Kaufman JM. (1999) Hypothalamic-pituitary-gonadal function in aging men. Aging Male 2:157–165.

    Google Scholar 

  2. Werner AA. (1946) The male climacteric: report of two hundred and seventy three cases. JAMA 132:188–183.

    Google Scholar 

  3. Morley J, Perry HM 3rd. (2003) Andropause: an old concept in new clothing. Clin Geriatr Med. 19:507–528.

    Article  PubMed  Google Scholar 

  4. Morales A, Lunenfeld B. (2002) Investigation, treatment and monitoring of late onset hypogonadism in males. Aging Male 5:74–86.

    Article  PubMed  CAS  Google Scholar 

  5. Feldman HA, Goldstein I, Hatzichristou, et al. (1994) Impotence and its medical and psychosocial correlates: Results of the Massachusetts Male Aging Study. J Urol 151:54–61.

    PubMed  CAS  Google Scholar 

  6. Braun M, Wassmer G, Klotz T, et al. (2000) Epidemiology of erectile dysfunction: results of the Cologne Male Survey. Int J Impot Res 12:305–311.

    Article  PubMed  CAS  Google Scholar 

  7. Marson L, McKeena KE. (1996) CNS cell groups involved in the control of the ischiocavernosus and bulbospongiosus muscles: a transneuronal tracing study using pseudorabies virus. J Comp Neurol 374:161–169.

    Article  PubMed  CAS  Google Scholar 

  8. Ferrini M, Wang C, Swerdloff RS, et al. (2001) Aging-related increased expression of inducible nitric oxide synthase and cytotoxic markers in rat hypothalamic regions associated with male reproductive function. Neuroendocrinology 74:1–12.

    Article  PubMed  CAS  Google Scholar 

  9. Chen H, Zirkin BR. (1999) Long term suppression of Leydig cell steroidogenesis prevents Leydig cell aging. Proc Natl Acad Sci USA 96:14,877–14,885.

    Article  PubMed  CAS  Google Scholar 

  10. Wang C, Hikim AS, Ferrini M, et al. (2002) Male reproductive aging: using the Brown Norway rat as a model for man. In: Endocrine Facets of Aging. Novartis Foundation Symposium 242. London, UK: Wiley, pp. 82–97.

    Chapter  Google Scholar 

  11. Veldhuis JD. (1997) Male hypothalamic-pituitary-gonadal axis. In: Lipshultz LA, Howards SS, eds., Infertility in the Male, 3rd Ed. St. Louis, MO: Mosby-Year Book, pp. 23–58.

    Google Scholar 

  12. Carani C, Bancroft J, Granata A, et al. (1992) Testosterone and erectile function, nocturnal penile tumescence and rigidity and response to erotic stimuli in hypogonadal and eugonadal men. Neuropsychoendocrinology 17:647–654.

    Article  CAS  Google Scholar 

  13. Traish AM, Park K, Dhir V, et al. (1999) Effects of castration and androgen replacement on erectile function in a rabbit model. Endocrinology 140:1861–1866.

    Article  PubMed  CAS  Google Scholar 

  14. Traish AM, Munarriz R, O’Conell L, et al. (2003) Effects of medical or surgical castration on erectile function in an animal model. J Androl 24:381–386.

    PubMed  Google Scholar 

  15. Wu XH, Hu LQ. (2002) Effect of androgen on penile erection induced by Larginine in the paraventricular nucleus Natl J Andrology 8:270–274.

    CAS  Google Scholar 

  16. Hinson JP, Raven PW. (1999) DHEA deficiency syndrome: a new term for old age? J Endocrinol 163:1–4.

    Article  PubMed  CAS  Google Scholar 

  17. Liu D, Dillon JS. (2002) Dehydroepiandrosterone activates endothelial cell nitric-oxide synthase by a specific plasma membrane receptor couplet to Gα(i2,3). J Biol Chem 277:21,379–21,387.

    Article  PubMed  CAS  Google Scholar 

  18. Williams MRI, Ling S, Dawood T, et al. (2002) Dehydroepiandrosterone inhibits human vascular smooth muscle cell proliferation independent of ARs and ERs. J Clin Endocrinol Metab 87:176–181.

    Article  PubMed  CAS  Google Scholar 

  19. Kawano H, Yasue H, Kitagawa A, et al. (2003) Dehydroepiandrosterone supplementation improves endothelial function and insulin sensitive in men. J Clin Endocrinol Metab 88:3180–3187.

    Article  CAS  Google Scholar 

  20. Simoncini T, Manella P, Fornari L, et al. (2003) Dehydroepiandrosterone modulates endothelial nitric oxide synthesis via direct genomic and nongenomic mechanisms. Endocrinology 144:34–41.

    Article  CAS  Google Scholar 

  21. Baulieu EE. (2001) Neurostéroides, leur rôle dans le fonctionnement du cerveau: neurotrophicité, mémoire, vieillissement. Bull Acad Natle Méd 185:349–356.

    CAS  Google Scholar 

  22. Zwain IH, Yen SSC. (1999) Dehydroepiandrosterone (DHEA): biosynthesis and metabolism in the brain. Endocrinology 81:233–242.

    Google Scholar 

  23. Morales A, Johnson B, Heaton JPW, Lundie M. (1997) Testosterone supplementation in hypogonadal impotence: assessment of biochemical measurements and therapeutic outcomes. J Urol 157:849–854.

    Article  PubMed  CAS  Google Scholar 

  24. Morley JE. (2003) Testosterone and behavior. Clin Geriatr Med 19:605.

    Article  PubMed  Google Scholar 

  25. Aversa A, Isidori AM, Spera G, et al. (2003) Androgens improve vasodilation and response to sildenafil in patients with erectile dysfunction. Clin Endocrinol (Oxf) 58:632–636.

    Article  CAS  Google Scholar 

  26. Shabsigh R, Kaufman JL, Steidle C. (2003) Testosterone replacement therapy with testosterone gel 1% converts sildenafil non-responders to responders in men with hypogonadism and erectile dysfunction who failed prior sildenafil therapy. J Urol 169:247 (abstract 954).

    Google Scholar 

  27. Kalinchenko SY, Kozlov GI, Gontcharov NP, Katsiya GV. (2003) Oral testosterone undecanoate reverses erectile dysfunction associated with diabetes mellitus in patients failing on sildenafil citrate therapy alone. Aging Male 6:94–99.

    Article  PubMed  CAS  Google Scholar 

  28. Rosenthal B, Ginsberg PC, Metro M, Hacaway RC. (2003) The addition of testosterone to treat erectile dysfunction after failure of sildenafil alone in men with acquired androgen deficiency syndrome. J Urol 169:377 (abstract 1408).

    Article  Google Scholar 

  29. Morales AJ, Haubrich RH, Hwang JY, et al. (1998) The effect of six months treatment with a 100 mg daily dose of dehydroepiandrosterone (DHEA) on circulating sex steroids, body composition and muscle strength in age-advanced men and women. Clin Endocrinol 49:421–426.

    Article  CAS  Google Scholar 

  30. Flynn MA, Weaver-Osterholtz D, Sharpe-Timms KL, et al. (1999) Dehydroepiandrosterone replacement on aging humans. J Clin Endocrinol Metab 84:1527–1532.

    Article  PubMed  CAS  Google Scholar 

  31. Artl W, Callies F, Koehler I. (2001) Dehydroepiandrosterone supplementation in healthy men with an age-related decline of dehydroepiandrosterone secretion. J Clin Endocrinol Metab 86:4686–4693.

    Article  Google Scholar 

  32. Baulieu EE, Thomas G, Legrain S, et al. (2000) DHEA, DHEA sulfate and aging: contribution of the DHEA age study to a sociobiomedical issue. Proc Nat Acad Sci USA 97:4279–4288.

    Article  PubMed  CAS  Google Scholar 

  33. Reiter WJ, Pycha A, Schatzl G, et al. (2000) Serum dehydroepiandrosterone sulfate concentrations in men with erectile dysfunction. Urology 55:755–759.

    Article  PubMed  CAS  Google Scholar 

  34. Reiter WJ, Pycha A, Schatzl G, et al. (1999) Dehydroepiandrosterone in the treatment of erectile dysfunction: a prospective, double-blind, randomized, placebo-controlled study. Urology 53:590–594.

    Article  PubMed  CAS  Google Scholar 

  35. Labrie F, Diamond P, Cusan L, Candes B. (1997) Effect of 12 month dehydroepiandrosterone replacement therapy on bone, vagina, and endometrium in postmenopausal women. J Clin Endocrinol Metab 82:3498–3506.

    Article  PubMed  CAS  Google Scholar 

  36. Schaison G, Couzinet B. (1998) Percutaneous dihydrotestosterone (DHT) treatment. In: Nieschlag E, Behre HM, eds., Testosterone: Action, Deficiency, Substitution. Berlin, Germany: Springer Verlag, pp. 423–436.

    Google Scholar 

  37. de Lignieres B. (1993) Transdermal dihydrotestosterone treatment of “andropause.” Ann Med 25:235–241.

    PubMed  Google Scholar 

  38. Ly LP, Jimenez M, Zhuang TN, et al. (2001) A double-blind, placebo-controlled, randomized clinical trial of transdermal dihydrotestosterone gel on muscular strength, mobility, and quality of life in older men with partial androgen deficiency. J Clin Endocrinol Metab 86:4078–4085.

    Article  PubMed  CAS  Google Scholar 

  39. Kunelius P, Lukkarinen O, Hannuksela ML, et al. (2002) The effects of transdermal dihydrotestosterone in the aging male: a prospective, randomized, double blind study. J Clin Endocrinol Metab 87(4):1467–1472.

    Article  PubMed  CAS  Google Scholar 

  40. Conway AJ, Boylan LM, Howe C, et al. (1998) Randomized clinical trial of testosterone replacement therapy in hypogonadal men. Int J Androl 11:247–253.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Urology, Queens University, Kingston General Hospital, Kingston, Ontario, Canada

    Alvaro Morales MD & Jeremy P. W. Heaton MD

Authors
  1. Alvaro Morales MD
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  2. Jeremy P. W. Heaton MD
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Editor information

Editors and Affiliations

  1. Department of Urology, Mayo Clinic College of Medicine, Jacksonville, FL

    Gregory A. Broderick MD

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© 2005 Humana Press Inc., Totowa, NJ

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Morales, A., Heaton, J.P.W. (2005). Androgen Deficiency in the Aging Male. In: Broderick, G.A. (eds) Oral Pharmacotherapy for Male Sexual Dysfunction. Current Clinical Urology. Humana Press. https://doi.org/10.1385/1-59259-871-4:279

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  • DOI: https://doi.org/10.1385/1-59259-871-4:279

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-451-7

  • Online ISBN: 978-1-59259-871-7

  • eBook Packages: MedicineMedicine (R0)

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