Abstract

Man above 50 years old, as women who experience menopause, will show certain and specific problems. Middle age man often has a group of complaints, symptoms and syndromes that almost the same as women. The total populationof old citizen in the whole world keeps on increasing from year to year; so in Indonesia. There was prediction that the increment of total of old population in Indonesia will increase into 41% in 2020 (WHO report). With the addition of age, there is a decrease of testosterone production and it will be followed with the decrease of production of other hormones, enzymes, bio active that needed by body to be able to survive in performing active and healthy life. Massachusetts Male Aging Study (MMAS, 1991) and Vermeulen (1992) report that start from 40 years old, a man will experience the decrease of active blood testosterone level around 1.2% per year and it happens until the age 70 years old, in which the man will experience blood testosterone level decrease into 35% from previous normal level. Testosterone Deficiency Syndrome (TDS) or Hypogonadism can be diagnosed well by measuring active testosterone level in laboratory Metabolic syndrome is a group of metabolic disorder, in which lipid or non lipid can be the factor of coronary disease, that consists of centralobesity, displipedimia alerogenic (high trigliserid level and low level of HDL cholesterol), hypertension, and abnormal glucoseplasma, and it often experienced by man above 40 years old. A man with erection dysfunction is initial manifestation of vascular disease. Risk factor for cardiovascular disease such as hypertension, dislipidemia, central obesity and insulin resistance is also the same risk factor for erection dysfunction that caused by vascular. Risk factor of erection dysfunction will increase for metabolic syndrome.