[Do we need the concept of male climacteric?].

The female menopause is considered to be a result of a decrease in the endocrinal metabolic activity of the ovaries. Although the male lacks such a highly visible sign as the cessation of the menstrual flow, the amount of testosterone produced by the aging male does in fact decrease. Recent studies, such as the Massachusetts Male Aging Study show that, between the ages of 40 to 70 years, the mean testosterone level decreases annually by about 1%. Chronic diseases and the use of drugs have a comparable effect. Although it is generally believed that sexual impotence is a major symptom of male menopause, recent investigations have shown that sexual functionability may be preserved into the ninth and tenth decade of life. Sexuality is not merely an instinct or a psychological expression, but is deeply anchored within the personality. Even when, with increasing age, the frequency of sexual dysfunction increases, such changes do not correlate with the decrease in testosterone levels. None of these phenomena take place within an age span that marks them off from the involution processes in other organs. The expression midlife crisis commonly met with in the English literature points up the psycho-social implications. Impotence or a loss of sexuality is not a sequel of aging, but of attitude towards sexuality. The latter is preserved if it is not neglected throughout the course of a lifetime.