Hormonal changes and sexual function in aging men.

A cross-sectional study on 220 men, aged 41-93 yr, was conducted to determine whether age-related changes in circulating pituitary and gonadal hormone levels are related to quantitatively assessed changes in sexuality over this age span. The conclusion of most previous studies, that total and free plasma testosterone (T) levels decline with advancing age as gonadotropins increase, was corroborated. These changes were found to roughly parallel a decline in sexual function affecting the level of sexual activity, libido, and potency measures. PRL and estradiol did not change with age, and the age-related decline in free T was greater than that in total T. Decreases in free T and increases in LH manifested significant, but small, correlations with sexual hypofunction. Behavioral variables were also clearly related to LH and to the ratio of free T to LH and estradiol. The data also suggested that aging and hormonal changes were more strongly related to sexual activity and nocturnal erections that to libido (enjoyment, drive, and thoughts). Partial correlation procedures demonstrated that diseases and drugs were not responsible for the hormone-behavior relationships. Declining androgen levels, reduced sexual activity, and decreased sexual interest thus appear to be related sequelae of the aging process in men. Hormonal factors do not completely account for age-related changes in sexuality, although the full explanation of these changes must include a consideration of hormonal factors.