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The world is experiencing a demographic transition with a rapidly mounting population over the age of 50 years. The global increases in life expectancy and sharp declines in fertility rates underlie the current, rapid age-specific population growth. Population projections indicate that diseases associated with aging will increase significantly during the first half of this century. The population older than 60 years will increase from world-wide 593 millions in 1999 to 1.97 billions in 2050, constituting about 10% of the total world population in 1999 and 22% in 2050, with the majority in developing countries. As male hypothalamic-pituitary-gonadal function declines progressively with age, about 15-25% of men above the age of 50 years will experience serum testosterone levels well below the threshold considered to be normal for men between 20 and 40 years of age. These men experience a varying set of symptoms, collectively addressed as "male hypogonadism". The signs and symptoms normally progress slowly and subtly over the years. Consequently, the patient sometimes is unaware or considers the symptoms as part of the normal, untreatable ageing process. The signs and symptoms of hypogonadism are numerous and include: a decreased sense of well-being, a decrease in muscle mass, strength and energy, increase in visceral fat, decrease in bone mass (potentially leading to osteoporosis), reduced virility, libido, and sexual activity, increased frequency of impotence, increases in sweating, mood changes, fat mass, dry skin, and anaemia. The symptoms of hypogonadism may be multifactorial in their origin, since other hormones than androgens decline with age as well. If the diagnosis of age related hypogonadism is supported by the trio- "clinical examination, symptoms and laboratory data" intervention studies indicate that testosterone therapy may produce a wide range of benefits for men with hypogonadism. Whilst female health has been the focus of a coherent medical approach over many years, the healthcare of males in their aging years has tended to be neglected. The International Society for the Study of the Aging Male (ISSAM) has, therefore, sought to redress this matter by taking a number of initiatives in the field of men's health. The objective of the society is to promote research, study and education on all matters relating to men's health after the age of 30. It is the society's aim to encourage physicians and other health-care professionals to understand male illness in the context of the aging process as a whole and to adopt a multi-disciplinary approach to caring for male patients. More specifically, the Society sets out to promote the concept of healthy aging. The programme "Aging Male 2004" offers selected key presentations and interviews concerning testosterone therapy in age related hypogonadism from the 4th World Congress on the Aging Male held in Prague, Czech Republic from 26-29 February 2004. This programme aims at supplying physicians who take special interest in men's health with relevant information and the latest discussions around testosterone therapy. The next meeting of ISSAM will be held in February 2006. For updates please visit www.issam.ch
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