[The male climacteric. A responsibility for dermatologic andrology?].

Sexual impotence is considered to be the main symptom of the male climacteric, corresponding to the female menopause. While the female climacteric is routinely observed and treated by gynecologists, there are no adequate institutions for the treatment of the corresponding male complaints. Like ovarian secretion of estrogens, which declines and thus causes the female climacteric syndrome, the endocrine metabolism of the testes decreases with increasing age. The period of this decrease, however, is far more extended than that of estrogen secretion in women. Several recent studies have yielded evidence that any disease--irrespective of its kind--in the aging man influences the decrease of testosterone levels more markedly than his age. In 1986 a study group in New England inaugurated the "Massachusetts Male Aging Study" in which healthy men in different age groups were tested for hormone levels. The most prominent result of this study was a decrease in mean testosterone levels by 1% and a decrease in the mean free testosterone levels by 1.2% per year of age. The study also allows recommendations for hormone substitution. The decrease in sexual function in the aging male does not correlate with the decrease in testosterone production. In summary, however, there is no doubt that the frequency of sexual dysfunction increases with advancing age, partly because of drug interactions. As there does not seem to be any sound basis for assuming an endocrine basis for the male climacteric, other reasons must probably be sought for the male climacteric or mid-life crisis.(ABSTRACT TRUNCATED AT 250 WORDS)