A clinical syndrome in aging men characterized by a progressive, often gradual, decline in bioavailable testosterone levels, leading to corresponding clinical symptoms. This condition is also known by the more scientifically precise term, Late-Onset Hypogonadism (LOH). Symptoms may include decreased libido, erectile dysfunction, loss of muscle mass, increased visceral fat, and diminished vitality. The diagnosis relies on both consistent symptoms and laboratory confirmation of low serum testosterone concentrations.
Origin
The term “andropause” was coined to parallel the female experience of menopause, suggesting a similar definitive cessation of reproductive function, though the male decline is typically slower and less universal. The etymological roots combine andro (man) and pausis (cessation). The clinical understanding has evolved from a simple hormonal deficiency to recognizing a complex interaction between age, lifestyle, and the hypothalamic-pituitary-gonadal (HPG) axis function.
Mechanism
The primary mechanism involves age-dependent changes in the testes, hypothalamus, and pituitary gland, leading to reduced testosterone synthesis and secretion. Specifically, there is often a decrease in the pulsatile release of Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH) from the pituitary, coupled with reduced Leydig cell responsiveness in the testes. Increased Sex Hormone-Binding Globulin (SHBG) production with age further reduces the biologically active free testosterone fraction, contributing significantly to the symptomatic presentation.
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