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Understanding how Age-Related Decline in Testosterone Affects Male Sexual Behavior: Neurosteroids as the Missing Piece

  • Preclinical and Psychophysiology (F Guarraci and L Marson, Section Editors)
  • Published:
Current Sexual Health Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Age-related declines in male sexual behavior are often attributed to a well-documented decline in circulating androgens. Yet, several recent studies and metanalyses have suggested a weak relationship between circulating androgen levels and sexual behaviors, indicating that despite decreases in circulating androgens many men maintain moderate levels of sexual behavior. The lack of a strong relationship between circulating androgens and sexual dysfunction may be due to age-related changes in steroid signaling in the brain, which may be independent of circulating androgens. Androgen concentrations, synthesis, and signaling in the aging brain have been understudied. The purpose of this review is to briefly summarize our understanding of how age-related decreases in circulating androgens influence neural circuits that mediate sexual behavior and reward, and to highlight recent findings in our understanding of androgen receptors, neuroandrogens, and sexual function in healthy aged men.

Recent Findings

Age-related declines in circulating androgens weakly correlate with declines in sexual behavior, but androgen decline does not account for all the variance in sexual behavior observed among subjects. Evidence now suggests that neural nodes of the consummatory and appetitive sexual behavior circuits are capable of synthesizing androgens, independent of circulating levels of androgens. However, there remains a lack of controlled studies on neural markers of androgen signaling in healthy aged men. This ability to locally regulate androgens may compensate for lower circulating androgen levels to maintain proper sexual functioning.

Summary

To better understand age-related declines in sexual behavior, compensatory androgen synthesis in the brains of aged males should be explored further in humans and animal models. A greater understanding of these mechanisms can inform the development of pharmacotherapies that can be used to ameliorate age-related sexual dysfunction.

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Abbreviations

3β-HSD:

3 Beta-hydroxysteroid dehydrogenase/isomerase

5αR:

5α-reductase

17β-HSD:

17 Beta-hydroxysteroid dehydrogenase

AE:

Androstenedione

AR:

Androgen receptor

BBB:

Blood-brain barrier

DHEA:

Dehydroepiandrosterone

DHEA-S:

Dehydroepiandrosterone sulfate

DHT:

Dihydrotestosterone

E2 :

17β-estradiol

LH:

Luteinizing hormone

NAc:

Nucleus accumbens

PFC:

Prefrontal cortex

PREG:

Pregnenolone

PREG-S:

Pregnenolone sulfate

T:

Testosterone

VTA:

Ventral tegmental area

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Acknowledgments

I would like to thank Dr. Desiree Seib and Mr. Jordan Hamden for helpful edits on previous versions of this manuscript. I would also like to thank Dr. Kiran Soma for financial support during the writing of this manuscript.

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  1. Department of Psychology, The University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, Canada

    Daniel J. Tobiansky

  2. Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, 2211 Wesbrook Mall, S241 Koerner Pavilion, Vancouver, BC, V6T 1Z4, Canada

    Daniel J. Tobiansky

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This article is part of the Topical Collection on Preclinical and Pscyhophysiology

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Tobiansky, D.J. Understanding how Age-Related Decline in Testosterone Affects Male Sexual Behavior: Neurosteroids as the Missing Piece. Curr Sex Health Rep 10, 305–314 (2018). https://doi.org/10.1007/s11930-018-0175-0

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