Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 71

Testicular volume is reduced slightly, while sperm production decreases dramatically with age. Testosterone production from the testes decreases and causes a loss of muscle mass and libido. Prostatic hyperplasia is seen frequently in older men, with a prevalence of one in three men over the age of 70. There are no effective methods for preventing prostatic hyperplasia, but symptom control is key for treatment. An excessively enlarged prostate gland may obstruct the urethra in older men, which is a cause of overflow incontinence.⁶⁹

The ovaries become atrophic in older women, and cyclic ovulation ends with menopause. Oestrogen production from the ovaries decreases, which has many effects on bones, genitals, and the metabolism. The effects of oestrogen on bones and metabolism are described in other chapters in this edition.

Vaginal prolapse is another issue aggravating LUT symptoms in older women. Vaginal prolapse is related to incontinence and a feeling of irritation. Vaginal dryness and changed flora are important consequences of decreased oestrogen. In addition, endometrial atrophy occurs in the absence of oestrogen with age.⁷⁰