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Older Age Does Not Cause Testosterone Levels To Decline In Healthy Men

Second study finds older men more likely to lose the ability to orgasm due to gabapentin

June 14, 2011 - A decline in testosterone levels as men grow older is likely the result - not the cause - of deteriorating general health, say Australian scientists, whose new study finds that age, in itself, has no effect on testosterone level in healthy older men.

The results, presented recently at The Endocrine Society's 93rd Annual Meeting in Boston, are the first findings released from the Healthy Man Study, according to principal investigator David Handelsman, MD, PhD, professor and director of the ANZAC Research Institute at the University of Sydney.

 

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"Some researchers believe that an age-related testosterone deficiency contributes to the deteriorating health of older men and causes nonspecific symptoms, such as tiredness and loss of libido," he said.

Handelsman and his team, however, found that serum (blood) testosterone levels did not decline with increasing age in older men who reported being in excellent health with no symptoms to complain of.

"We had originally expected age to have an effect on serum testosterone, so the findings were a bit of a surprise," Handelsman said.

Two study centers in Australia recruited 325 men over the age of 40 (median age, 60) who had self-reported excellent health and no symptom complaints. To test blood testosterone levels, the researchers took blood samples from the men nine times over three months. They excluded men from the study who took medications that affect testosterone.

Obesity caused a mild and clinically unimportant lowering of blood testosterone levels, the investigators reported. Age had no effect on testosterone level.

"The modest decline in blood testosterone among older men, usually coupled with nonspecific symptoms, such as easy fatigue and low sexual desire, may be due to symptomatic disorders that accumulate during aging, including obesity and heart disease," he said. "It does not appear to be a hormone deficiency state."

The message for patients and their doctors, Handelsman said, is "older men with low testosterone levels do not need testosterone therapy unless they have diseases of their pituitary or testes."

This research was supported by the MBF (Medical Benefits Fund) Foundation in Sydney, which is part of the private health insurer Bupa.

Older men more likely to lose the ability to orgasm due to gabapentin

Researchers, in another recent study, have found that Gabapentin, (trade name Neurontin) a medication commonly used to treat neuropathic pain, seizures and biopolar disease in older and elderly patients, seems to have a higher incidence of failure to experience orgasm (anorgasmia), than previously reported.

This study from Boston University School of Medicine (BUSM) appears in the current issue of the American Journal of Geriatric Pharmacotherapy.

Anticonvulsants are the fastest growing prescribed medication in the baby boomer generation. In patients 44-82 years old, anticonvulsants are more commonly prescribed than opioids. Gabapentin is a preferred medication, given its perceived benign side effects, typically limited to somnolence and dizziness that resolve with time.

Since its introduction in 1993, only 10 cases of anorgasmia have been reported, mostly in younger patients with an average age of 38 years. In this case study, three of the 11 patients who were over the age of 50 experienced anorgasmia.

These male patients were 73, 76 and 78 years old. Interestingly, another case in a 59-year-old female was noted by colleagues at Tufts Medical Center.

"This is a much higher incidence than was reported in the original clinical trials. Gabapentin induced anorgasmia may be more common in older patients," according to lead author Michael D. Perloff, MD, PhD, an assistant professor neurology at BUSM. "Further, anorgasmia appears to be dose dependent. In all cases orgasm returned when Gabapentin was reduced or stopped."

The researcher recommends that clinicians should review the potential for anorgasmia with patients taking Gabapentin or discuss it at follow up.

"If anorgasmia does occur, patients should be reassured that it is reversible and likely dose dependent," added Perloff.

 

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