Androgen deficiency in the aging male: Pathophysiology, diagnosis, and treatment alternatives

Flynn, Vincent J.

doi:10.1007/s11934-001-0042-8

Cited by 8 publications

(4 citation statements)

References 59 publications

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“…Antagonist treatment would, however, be contingent on the development of an agent that prevented the translocation of the AR to the nucleus. Long‐term androgen ablation would have a number of detrimental effects including impaired muscle strength, osteoporosis, decreased libido and mood effects 62,63 . Given that long‐term androgen ablation, such as castration, would be profoundly detrimental, both physically and mentally, the knowledge that blocking androgen synthesis might decrease disease progression raises the possibility that maybe short‐term androgen reduction could be a feasible treatment.…”

Section: Therapeutic Approachesmentioning

confidence: 99%

Kennedy's disease: pathogenesis and clinical approaches

Greenland

Zajac

2004

Internal Medicine Journal

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Kennedy's disease, also known as spinal and bulbar muscular atrophy, is a progressive degenerative condition affecting lower motor neurons. It is one of nine neurodegenerative disorders caused by a polyglutamine repeat expansion. Affecting only men, Kennedy's disease is the only one of these conditions that follows an X-linked mode of inheritance. The causative protein in Kennedy's disease, with a polyglutamine expansion residing in the first N-terminal domain, is the androgen receptor. Research in this field has made significant advances in recent years, and with the increased understanding of pathogenic mechanisms, feasible approaches to treatments are being investigated. In Kennedy's disease research, the most significant issue to emerge recently is the role of androgens in exacerbating the disease process. On the basis of animal experiments, a viable hypothesis is that higher circulating levels of androgens in men could trigger the degeneration of motor neurons causing this disease, and that lower levels in heterozygous and homozygous women are protective. This is a major issue, as treatment of individuals affected by Kennedy's disease with testosterone has been considered a reasonable therapy by some neurologists. The rationale behind this approach relates to the fact that Kennedy's disease is accompanied by mild androgen insensitivity. It was therefore believed that treatment with high doses of testosterone might compensate for this loss of androgen action, with the added benefit of preventing muscle wasting. The current review provides an overview of recent advances in the field of Kennedy's disease research, including approaches to treatment.

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Section: Therapeutic Approachesmentioning

confidence: 99%

Kennedy's disease: pathogenesis and clinical approaches

Greenland

Zajac

2004

Internal Medicine Journal

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“…Tender breasts and gynecomastia occur in a small proportion of older men on HRT [11][12][13][14][15] . A relatively greater percentage increase in serum estrogen levels as compared to serum testosterone levels may contribute to the changes in the breasts.…”

Section: Gynecomastiamentioning

confidence: 99%

“…In the younger adult hypogonadal male, there are a number of detrimental changes in the organs and their functions accompanying the normal aging process that might be positively influenced by Hormone Replacement Therapy (HRT) ( Table 1) [2][3][4][5][6][7][8][9][10][11][12][13][14][15] . Among these age-related changes are a decrease in muscle tissue mass and a decline in muscle strength 5,6 , an increase in body fat, a decline in bone mass, and an increased incidence of osteoporosis and minimal trauma fractures [7][8][9] , as well as a decline in the quality and quantity of sexual thoughts and enjoyment 10 .…”

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confidence: 99%

Risks and benefits of hormone replacement therapy in older men

et al. 2004

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The use of testosterone in older men, known as male hormonal replacement therapy or androgen replacement therapy, has become of increasing interest to both the medical and lay communities over the past decade. Even though the knowledge of the potential benefits and risks of male Androgen Replacement Therapy has increased dramatically, there is still much that needs to be determined. Although there are a number of potential benefits of male Androgen Replacement Therapy and data concerning clinical effects of such replacement have accumulated, as yet there have not been any large multicenter randomized controlled trials of this therapy. It is the purpose of this article to review what is currently known about the possible risks and benefits of male Androgen Replacement Therapy by discussing the clinical trials to date.

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“…In the mature adult they range from 600 to 700 ng/dL. As men age, androgen levels decline during the so-called andropause, reaching 450 to 500 ng/dL in their seventies and eighties [ Flynn and Hellstrom, 2001 ]. Concomitantly, lean body mass decreases and older men are frailer, with a greater tendency to falls and bone fractures.…”

Section: Pharmacology Of Androgensmentioning

confidence: 99%

Therapeutic androgen receptor ligands

Allan

Sui

2003

Nuclear Receptor Signaling

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In the past several years, the concept of tissue-selective nuclear receptor ligands has emerged. This concept has come to fruition with estrogens, with the successful marketing of drugs such as raloxifene.The discovery of raloxifene and other selective estrogen receptor modulators (SERMs) has raised the possibility of generating selective compounds for other pathways, including androgens (that is, selective androgen receptor modulators, or SARMs).

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Androgen deficiency in the aging male: Pathophysiology, diagnosis, and treatment alternatives

Cited by 8 publications

References 59 publications

Kennedy's disease: pathogenesis and clinical approaches

Kennedy's disease: pathogenesis and clinical approaches

Risks and benefits of hormone replacement therapy in older men

Therapeutic androgen receptor ligands

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