“雄激素革命”为期不远
http://www.100md.com
2001年2月18日
纽约路透社健康消息 从20岁到70岁，男性体内的雄激素水平可以下降50%。因此越来越多的医学专业人士把这种现象称为“男性更年期”，类似于女性的的绝经期。许多人认为，在不久的将来，雄激素替代疗法将会象雌激素替代疗法让绝经后妇女重获活力一样，令老年男士返老还童，青春常在。
雄激素的水平有很强的个体特异性，即使是有正常雄激素水平的人也会出现雄激素缺乏症状。这些症状包括抑郁、性欲下降、精神萎靡、骨质疏松以及肌力量下降等。评价一个人是否需要额外的雄激素，包括肌肉/脂肪比、骨密度、精神状况以及性能力。
英国伦敦内科医生和化学病理学家马尔科姆·加鲁瑟认为，在严密监测下用雄激素替代疗法治疗雄激素水平低下是安全且对男性健康有益的。这种治疗方法不仅不会增加前列腺癌的发病率，而且对心脏和体循环有好处，还可以预防骨质疏松，甚至预防老年痴呆病。纽约的西奈山医学院男性生殖医学和外科主任纳坦巴查马医生则认为，给这种雄激素水平较低的男士补充雄激素可以强壮骨骼，增加肌肉的质量、改善认知功能和性欲以及对抗抑郁。
, http://www.100md.com
虽然对雄激素替代疗法的危险性的研究已经持续了很久，但早期的研究结果并不能完全证明这种疗法会增加前列腺癌的发病率。新产品雄激素凝胶和膏药已经使雄激素替代疗法更加安全，因为这种给药方式并不会超过生理正常范围，而药丸和针剂给药就有可能过量。
医学界对雄激素替代疗法仍然存在争议。有研究者怀疑，额外补充雄激素会刺激前列腺癌的生长。健身者和运动员滥用雄激素已经造成很坏的影响；但也有研究说许多人可以从补充雄激素中获益。雄激素减少脂肪和增加肌肉质量的作用，不仅仅是美容，还有助于预防心脏病和减缓心脏病的发展。
目前男性更年期领域的研究还在起步阶段，比女性绝经期的研究至少要落后十年左右的时间。在今后的5-10年里，预计有更多学者会对这一领域的研究感兴趣。
‘Testosterone Revolution‘ Urged for Older Men
, 百拇医药
NEW YORK (Reuters Health) - Testosterone supplementation could one day help keep men fit, active and happy well into old age, just as estrogen lends vitality to postmenopausal women, a doctor suggests.
Between age 20 and 70, a man‘s testosterone level may drop as much as 50%. A growing number of medical professionals refer to this decline as ``andropause‘‘--analogous to menopause in women.
However, hormone replacement therapy for men remains controversial. Some researchers suspect extra testosterone could spur the growth of prostate cancer, and the illicit use of the hormones by bodybuilders and other athletes has also tainted its image.
, http://www.100md.com
According to Dr. Malcolm Carruthers, carefully monitored testosterone supplementation for men deficient in the hormone is safe and has many health benefits.
``It‘s not only okay for the prostate; it‘s actually good for the heart and circulation, prevents osteoporosis, and has many of the benefits--including possibly preventing Alzheimer‘s--that female hormone replacement therapy does,‘‘ Carruthers, a physician and chemical pathologist in private practice in London, told Reuters Health.
, 百拇医药
Carruthers has launched a charity, The Andropause Society, to study and support research in this area. He is also a consultant to AndroScreen.com, a Web site offering information on screening for testosterone deficiency and access to treatment, and is working on building a worldwide network of doctors trained in treating testosterone deficiency.
Indeed, a growing body of evidence supports the idea that testosterone supplementation for men with low levels of the hormone can strengthen bone, increase muscle mass, improve cognitive function and libido, and fight depression, according to Dr. Natan Bar-Chama. Bar-Chama is director of male reproductive medicine and surgery at the Mt. Sinai School of Medicine in New York.
, http://www.100md.com
``The field of andropause is in its early stage,‘‘ the New York researcher told Reuters Health. ``We‘re probably a decade behind as compared to the field of menopause.‘‘ He said he expects interest in this area to grow dramatically in the next 5 to 10 years.
Although long-term studies on the risks of testosterone supplementation are not yet complete, Bar-Chama said, early results do not suggest it carries an increased risk of prostate cancer.
, http://www.100md.com
New testosterone gels and patches have made testosterone supplementation safer, Bar-Chama added. These medications increase testosterone but not beyond physiologically normal levels, as pills and injections have the potential to do.
Deciding who would benefit from testosterone supplementation requires looking at symptoms as well as hormone levels, both doctors agree.
Testosterone levels vary from person to person, and a man with normal levels may have symptoms of deficiency. These symptoms include depression, loss of interest in sex, poor mental function, osteoporosis and reduced muscle strength, according to Carruthers.
, 百拇医药
Evaluation of many factors, including muscle/fat ratio, bone density, mental function and sexual performance, is necessary to determine if a man needs extra testosterone, Bar-Chama said.
Testosterone‘s benefit of reducing fat and increasing muscle mass is not just cosmetic, he observed. Trimming fat and adding muscle can help prevent or slow the progress of heart disease.
``There are many men who can benefit from testosterone supplementation,‘‘ Bar-Chama said. ``There are tremendous benefits but there are also risks.‘‘
As the field of andropause develops, Bar-Chama predicts, doctors will more clearly define these risks and benefits and begin to reduce these risks, just as researchers working on menopause have worked to shrink the side effects of estrogen supplementation.
载自家庭医生医疗保健网, 百拇医药
雄激素的水平有很强的个体特异性，即使是有正常雄激素水平的人也会出现雄激素缺乏症状。这些症状包括抑郁、性欲下降、精神萎靡、骨质疏松以及肌力量下降等。评价一个人是否需要额外的雄激素，包括肌肉/脂肪比、骨密度、精神状况以及性能力。
英国伦敦内科医生和化学病理学家马尔科姆·加鲁瑟认为，在严密监测下用雄激素替代疗法治疗雄激素水平低下是安全且对男性健康有益的。这种治疗方法不仅不会增加前列腺癌的发病率，而且对心脏和体循环有好处，还可以预防骨质疏松，甚至预防老年痴呆病。纽约的西奈山医学院男性生殖医学和外科主任纳坦巴查马医生则认为，给这种雄激素水平较低的男士补充雄激素可以强壮骨骼，增加肌肉的质量、改善认知功能和性欲以及对抗抑郁。
, http://www.100md.com
虽然对雄激素替代疗法的危险性的研究已经持续了很久，但早期的研究结果并不能完全证明这种疗法会增加前列腺癌的发病率。新产品雄激素凝胶和膏药已经使雄激素替代疗法更加安全，因为这种给药方式并不会超过生理正常范围，而药丸和针剂给药就有可能过量。
医学界对雄激素替代疗法仍然存在争议。有研究者怀疑，额外补充雄激素会刺激前列腺癌的生长。健身者和运动员滥用雄激素已经造成很坏的影响；但也有研究说许多人可以从补充雄激素中获益。雄激素减少脂肪和增加肌肉质量的作用，不仅仅是美容，还有助于预防心脏病和减缓心脏病的发展。
目前男性更年期领域的研究还在起步阶段，比女性绝经期的研究至少要落后十年左右的时间。在今后的5-10年里，预计有更多学者会对这一领域的研究感兴趣。
‘Testosterone Revolution‘ Urged for Older Men
, 百拇医药
NEW YORK (Reuters Health) - Testosterone supplementation could one day help keep men fit, active and happy well into old age, just as estrogen lends vitality to postmenopausal women, a doctor suggests.
Between age 20 and 70, a man‘s testosterone level may drop as much as 50%. A growing number of medical professionals refer to this decline as ``andropause‘‘--analogous to menopause in women.
However, hormone replacement therapy for men remains controversial. Some researchers suspect extra testosterone could spur the growth of prostate cancer, and the illicit use of the hormones by bodybuilders and other athletes has also tainted its image.
, http://www.100md.com
According to Dr. Malcolm Carruthers, carefully monitored testosterone supplementation for men deficient in the hormone is safe and has many health benefits.
``It‘s not only okay for the prostate; it‘s actually good for the heart and circulation, prevents osteoporosis, and has many of the benefits--including possibly preventing Alzheimer‘s--that female hormone replacement therapy does,‘‘ Carruthers, a physician and chemical pathologist in private practice in London, told Reuters Health.
, 百拇医药
Carruthers has launched a charity, The Andropause Society, to study and support research in this area. He is also a consultant to AndroScreen.com, a Web site offering information on screening for testosterone deficiency and access to treatment, and is working on building a worldwide network of doctors trained in treating testosterone deficiency.
Indeed, a growing body of evidence supports the idea that testosterone supplementation for men with low levels of the hormone can strengthen bone, increase muscle mass, improve cognitive function and libido, and fight depression, according to Dr. Natan Bar-Chama. Bar-Chama is director of male reproductive medicine and surgery at the Mt. Sinai School of Medicine in New York.
, http://www.100md.com
``The field of andropause is in its early stage,‘‘ the New York researcher told Reuters Health. ``We‘re probably a decade behind as compared to the field of menopause.‘‘ He said he expects interest in this area to grow dramatically in the next 5 to 10 years.
Although long-term studies on the risks of testosterone supplementation are not yet complete, Bar-Chama said, early results do not suggest it carries an increased risk of prostate cancer.
, http://www.100md.com
New testosterone gels and patches have made testosterone supplementation safer, Bar-Chama added. These medications increase testosterone but not beyond physiologically normal levels, as pills and injections have the potential to do.
Deciding who would benefit from testosterone supplementation requires looking at symptoms as well as hormone levels, both doctors agree.
Testosterone levels vary from person to person, and a man with normal levels may have symptoms of deficiency. These symptoms include depression, loss of interest in sex, poor mental function, osteoporosis and reduced muscle strength, according to Carruthers.
, 百拇医药
Evaluation of many factors, including muscle/fat ratio, bone density, mental function and sexual performance, is necessary to determine if a man needs extra testosterone, Bar-Chama said.
Testosterone‘s benefit of reducing fat and increasing muscle mass is not just cosmetic, he observed. Trimming fat and adding muscle can help prevent or slow the progress of heart disease.
``There are many men who can benefit from testosterone supplementation,‘‘ Bar-Chama said. ``There are tremendous benefits but there are also risks.‘‘
As the field of andropause develops, Bar-Chama predicts, doctors will more clearly define these risks and benefits and begin to reduce these risks, just as researchers working on menopause have worked to shrink the side effects of estrogen supplementation.
载自家庭医生医疗保健网, 百拇医药