男性不妊症患者における男性更年期障害症状の調査

Abstract

男性不妊患者215名, 平均年齢35.1歳(24～63歳)を対象とし, 男性更年期障害(PADAM)調査を行った人間ドック受診者で30歳代の301人のデータを対照群と比較検討した.不妊患者群のうち勃起不全(ED)が33例(15.3%)に存在し, AM scale総合点では不妊患者群は対照群と比較して低値ではあるが有意差は認めず, 精神的機能, 身体的機能においては有意差を認めた.ED群は対照群に比べ高値を示したが有意差は認められず, 性的機能については有意に高値を示した.EDのない不妊群は対照群に比して低値を示し, 精神的機能, 身体的機能は有意に低値を示した.また, 不妊患者群の血清総テストステロン値とPADAM症状関連では両者に明らかな相関は認められなかった.男性不妊患者は性機能の低下や身体能力, 精神活動に影響を及ぼすPADAM症状を呈する頻度は低く, EDを自覚する患者でもQOLが比較的良好に保たれていた

There is a gradual decline in testosterone and free testosterone with age. Physical and psychological changes can occur due to this decline of androgens--a syndrome known as "partial androgen decline in the aging male" (PADAM). Male infertility and erectile dysfunction (ED) can also be caused by androgen deficiency. Thus, male infertility, ED and PADAM are interrelated. We evaluated the prevalence of PADAM symptoms in 215 infertile patients in an infertility clinic using the Aging Males Symptom (AMS) scale. Results of the evaluation of 301 men, (30-39 years old) using the same scale, who were part of a multiphasic health screening program, served as controls. The total score of the infertile patients was lower than that of the controls. Especially, the scores of the psychological and somatic subscales were significantly lower in infertile patients (P=0.009, P=0.012, respectively). Thirty three (15.3%) of the 215 infertile patients had ED. Although the score of sexual subscale was higher in the ED patients than in the controls, the scores of the psychological and somatic subscales were not significantly different from those in the controls. In conclusion, PADAM symptoms in Japanese infertile patients were not severe. Moreover, general function was better preserved in the infertile patients than in the controls. The psychological and somatic functions of ED patients were also well preserved.