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| Information | BACKGROUND Unlike women, who abruptly stop being fertile with menopause , men do not experience a sudden change in fertility. Instead, changes occur gradually during a process that some experts refer to as andropause. AGING CHANGES Aging changes in the male reproductive system occur primarily in the testes . Testicular tissue mass decreases. The level of the male sex hormone testosterone stays the same or decreases very slightly. The tubes that carry sperm may become less elastic (a process called sclerosis). The testes continue to produce sperm, but the rate of sperm cell production slows. The epididymis, seminal vesicles , and prostate gland lose some of their surface cells but continue to produce the fluid that helps carry sperm. The prostate gland enlarges with age as some of the prostate tissue is replaced with a "scar-like" fibrotic tissue. This condition, called benign prostatic hypertrophy , affects about 50% of men. In both men and women, reproductive system changes are closely related to changes in the urinary system. EFFECT OF CHANGES Fertility varies from man to man, and age is not a good predictor of male fertility. Prostate function is not closely related to fertility, and a man can father children even if his prostate gland is removed. Some fairly old men can (and do) father children. The volume of fluid ejaculated usually remains the same, but there are less number of living sperm in the fluid. Decreases in the "sex drive" (libido) may occur for some men. Sexual responses may become slower and less intense. This may be related to decreased testosterone level, but is more likely to result from psychological or social changes related to aging (such as lack of a willing partner), diseases and chronic illnesses, and medications. Aging by itself does not necessarily prevent a man from being able to have or enjoy sexual relationships. COMMON PROBLEMS Impotence may be a concern for aging men. It is normal for erections to occur less frequently than when younger, and aging men often have less ability to experience repeated ejaculation. However, impotence is most often the result of something other than simple aging. Medications (especially those used to treat hypertension and certain other conditions) can cause some men to be unable to develop or maintain an erection that is sufficient for intercourse. Disorders such as diabetes mellitus can also cause impotence. If impotence occurs, it can often be treated. Medications may be able to be changed, and other impotence treatments can be helpful. The primary health care provider or a urologist should be consulted if a man is concerned about possible impotence. Prostate hypertrophy can eventually interfere with urination. The enlarged prostate partially blocks the tube that drains the urinary bladder (urethra). Changes in the prostate gland predispose elderly men to urinary tract infections . Vesicoureteral reflux (back-up of urine into the kidneys) can develop if the bladder is unable to drain adequately, eventually resulting in kidney failure . Prostate gland infections or inflammation (various forms of prostatitis) can occur. cancer '>Prostate cancer becomes more common in aged men. It is one of the most frequent causes of cancer death for men. Bladder cancer is also a frequent cancer for older men. (Testicular cancers are possible but more often occur in younger men). PREVENTION Many of the physical age-related changes (prostate enlargement, testicular atrophy, and so on) are not preventable. Impotence that is caused by medications, illness, and so on is often successfully treated. Sexual response changes are most frequently related to factors other than simple aging. Sex is more likely if a willing partner is available and if sexual activity has continued during middle age. RELATED TOPICS. aging changes in hormone production aging changes in organs, tissues, and cells aging changes in the female reproductive system aging changes in the kidneys |
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