Endocrinology of the aging male: the European Male Ageing Study (EMAS)
The relationships between alterations in hormones with the clinical features of senescence remain unclear in ageing men. We have investigated the natural history of and risk factors for potential adverse consequences associated with low testosterone in the European Male Ageing Study (EMAS), a population-based prospective cohort study of 3369 men (aged 4079 years) from the general population of 8 European countries. A wide variety of clinical variables pertinent to general, sexual, physical, musculo-skeletal and mental health were documented by standardised methods together with centrally-measured biochemical, hormonal and genetic markers. Some of the baseline cross-sectional data will be discussed in the context of the diagnosis of subclinical late onset hypogonadism, frailty and bone health and their relationship to testosterone deficiency and testosterone action will be presented. These data show that changes in many domains of health in ageing men are only weakly associated with alterations in hormone function. The concept of an ageing-related syndrome of hypogonadism may not be as widely applicable to men in the general population as previously suggested. The challenge is to identify the minority who may be appropriate candidates who are likely to benefit from hormone intervention.