No abstract

The influence of aging on serum levels of gonadotropins (FSH and LH), testosterone and estradiol was studied in the following groups: 4 normal men (ages 30 to 50), 38 men with symptoms of the male climacteric (ages 51 to 84), 25 men with relative impotence (ages 31 to 50), 10 normal women (ages 24 to 31), and 6 menopausal women (ages 58 to 76). FSH and LH levels began to rise in men in their 40's, and the increase became more conspicuous in the later age decades. The degree of elevation was nowhere comparable to that observed in the aging women. In the male, the serum testosterone levels showed a progressive decrease from the fifth age decade onward, whereas in the female there was an increase after the menopause. Estradiol levels showed no significant change in the aged male, but they were somewhat higher than in the aged female. Exceptions to the low-testosterone and low-gonadotropin relationship were observed in individual cases and might be explained by relatively high estradiol values. Proper replacement therapy by means of estrogens for the postmenopausal female and androgens for the aging male is often of great benefit, physically and emotionally.

The syndrome is only definitive when resolution occurs with the onset of menses or soon thereafter. Manifestations of PMS include: nervousness, depression, irritability, insomnia, headaches, breast enlargement, abdominal bloating, oedema, gastrointestinal upsets, skin disorders antisocial behavior and psychosexual aberrations. Hormonal changes are probably the main etiological factor and the newest approach to management consists of inhibition of ovulation by means of estradiol implants. Although emotional and psychiatric symptoms are prominent, psychiatric treatment is disappointing. PMS is simply a response to biochemical and metabolic changes following ovulation; distressing PMS represents a psychological maladjustment to these hormonal tides.