Diagnosis

Given that andropause/ADAM/PADAM is purported to be one form of hypo-gonadism, the phenomena described under "Assessment" above in this chapter, applies here as well.

Low sexual desire is usually seen as a symptom of andropause/ADAM/ PADAM. To explain the desire change, a great deal of emphasis has been given to laboratory values, especially alterations in T. However, the typical history has received much less attention. Only one study of aging men seems to have examined various manifestations of sexual desire. Schiavi et al. reported on 77 volunteer couples who responded to an announcement concerning a examination of factors contributing to health, well-being, and marital satisfaction in older men. Three groups of men were compared: 45 -54, 55 -64, and 65 -74. The following were conclusions related to the issue of sexual desire: (i) sexual interest, responsiveness, and activity was noted even among the oldest men; (ii) increasing age was associated with ED, but not with HSDD or PE (premature ejaculation); (iii) the following frequencies consistently decreased with age: desire for sex, sexual thoughts, maximum time uncomfortable without sex, coitus, and masturbation; and (iv) "... the degree of satisfaction with the men's own sexual functioning or enjoyment of marital sexuality did not change with age" (36, pp. 41 -53).

As far as the laboratory is concerned, measuring BAT is the preferred parameter for determining hypogonadism, although it is not always available (24). Abnormality is judged by comparing the T level with young adult men (23). "If the testosterone level is below or at the lower limit, it is prudent to confirm the results with a second determination with assessment of LH and... FSH."

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