[Hormone therapy in the aging male. Estrogen, DHEA, melatonin, somatotropin]

Abstract

The endocrine system of aging males reveals changes of more or less unknown significance for estrogens, dehydroepiandrosterone (DHEA), melatonin and growth hormone. The difference between physiological changes and clear hormone deficiency is not really understood and the clinical relevance of the observed changes needs to be investigated. Estrogens do not show any changes, but DHEA, melatonin or growth hormone show several changes in their concentrations concomitant with increasing age, without validated clinical significance. According to the guidelines of the ISSAM, the significance of changes in DHEA, DHEAS, melatonin, growth hormone and IGF-1 are not well enough understood to justify routine examination when investigating late-onset hypogonadism in aging men. There is no indication for treatment with these hormones (with the exception of, e.g., estrogens in prostate cancer or male-to-female-transsexualism), as the assumed positive effects as well as negative side effects are not clearly understood and need further investigation.