February 20, 2002
Men might not have the same sort of well-defined mid-life change that women go through with menopause. But a growing number of medical experts believe that men too can experience their own kind of hormone-related "change-of-life". Karen McGhee reports
Often referred to as andropause, it's a phenomenon or condition that usually begins sometime between the ages of 40 and 55 and is thought to be largely related to declining levels of the hormone testosterone. This is the hormone responsible for the development of deep voices and facial hair in men, but is also important in a wide range of ongoing metabolic activities in the body. It plays a role, for example, in maintaining bone density and the production of muscle tissue and red blood cells.
Andropause is also sometimes referred to as viropause, PADAM (Partial Androgen Deficiency in the Aging Male) and ADAM (Androgen Deficiency in the Aging Male). It was first described in the scientific literature as far back as the mid-1940s.
Although virtually all men experience a decline in testosterone as they age, only a few men will suffer the adverse affects of andropause. In those that do, the symptoms usually appear gradually and progress over many years. This is in sharp contrast to the comparatively well-defined onset of the female menopause.
Andropause can produce a wide range of symptoms, the severity of which can vary significantly between different men. Among the earliest signs can be a loss of libido and sexual dysfunction, including erection failures. Other symptoms may include lethargy, grumpiness, a general lack of interest in life, increased anxiety, forgetfulness, insomnia and depression.
Men can also suffer from a loss of muscle mass and a decrease in bone density which, just as occurs in women, can lead to osteoporosis < a debilitating condition in which the bones become brittle and more susceptible to fractures.
Blood tests are the starting point to tell whether you are experiencing the hormonal imbalances thought to be responsible for the symptoms of andropause or some other underlying condition. However, it may also be worthwhile considering the following series of questions before getting to that point, it can be worth considering the following series of questions devised as a screening test for the condition by Dr John Morley from the St Louis University School of Medicine.
1. Do you have a decrease in libido?
2. Do you have a lack of energy?
3. Do you have a decrease in strength and/or endurance?
4. Have you lost height?
5. Have you noticed a decreased "enjoyment of life"?
6. Are you sad and/or grumpy?
7. Are your erections less strong?
8. Have you noticed a recent deterioration in your ability to play sports?
9. Are you falling asleep after dinner?
10. Has there been a recent deterioration in your work performance?
If you answer yes to questions number 1 and 7 or a combination of at least three of the other questions you should talk to your doctor about whether andropause could be responsible.
However it is important to note that some of these symptoms could be caused by another condition such as cancer, diabetes or a heart problem. Your doctor would be the best one to advise you here.
Sometimes, it's not so much an overall reduction in testosterone that can cause the symptoms of andropause but a reduced ratio of testosterone compared to levels of another hormone, estrogen. Most people think of this as a female hormone but men produce it too and increasingly so with age.
Obesity, a zinc deficiency, liver problems, excessive alcohol consumption and some prescription drugs such as diuretics used to treat high blood pressure can all contribute to unhealthily elevated estrogen levels in men.
There's a range of treatments available for the individual symptoms of andropause. For example, antidepressants can be prescribed to combat the overwhelming sense of despair that occurs in some men and, during the last decade, Viagra has become a highly effective treatment for impotence problems.
Testosterone Replacement Therapy can either be an injection given every 4 weeks, or a topical patch may be used if blood tests confirm clinical suspicions.
When having TRT, the patient requires close medical monitoring because unnecessary administration can lead to a thickening of blood vessels and risk of stroke. There are also concerns too that TRT can increase a patient's chance of developing prostate cancer and may also have deleterious affects on the heart.
The length of treatment is dependent on lifestyle and other medical illnesses.
Lifestyle changes - such as improving your diet, taking regular exercise, reducing stress, giving up smoking and limiting alcohol intake - may also help in reducing the symptoms of andropause.
By Karen McGhee
Reprinted with permission from Editforce