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Stochastic damage accumulating within ageing leads to progressive dysregulation at each level of the hypothalamic\u2013pituitary\u2013gonadal (HPG) axis and in local auto\/paracrine interactions, thereby inducing morphological changes in reproductive target organs, such as the prostate, testis and penis. Despite age\u2010related changes in the HPG axis, endocrine functions are generally sufficient to maintain fertility in elderly men. Ageing of the male reproductive system can give rise to clinically relevant manifestations, such as benign prostatic hyperplasia (BPH), prostate cancer (PCa) and erectile dysfunction (ED). In this review, we discuss morphological\/histological changes occurring in these organs and current views and concepts of the underlying pathology. Moreover, we emphasize the molecular\/cellular pathways leading to reduced testicular\/penile function and proliferative disorders of the prostate gland. Copyright \u00a9 2007 Pathological Society of Great Britain and Ireland. 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