Male Menopause

Male Menopause

Male menopause (also referred to as andropause or late-onset hypogonadism) is clinically defined as age related changes in the hormonal metabolism of males. Study reported in the peer reviewed Journals of Gerontology Series (1) suggested that testosterone levels in males declines progressively after 30 years of age. In fact, according to latest statistics, more than 50% males over the age of 80 are testosterone deficient.

Pathophysiology Of Male Menopause

Clinical studies suggests that physiological aging plays a major role in the normal metabolism of all the endocrine hormones. With advancing age, the capacity of gonads to produce testosterone decreases. Study reported in Urology Reviews journal (2) also suggested that the sensitivity of peripheral tissues to androgens also decreases with age; which further deteriorates the situations. Other factors that may negatively impact testosterone metabolism in aging males are, obesity, stressful lifestyle and poor nutritional choices. Unlike females in whom hormonal changes are abrupt and noticeable (i.e. cessation of menstruation and loss of fertility), effects are less pronounced in males but are often subtle enough to warrant a treatment.   

Based on latest estimates, more than 5 million men in United States are currently living with inadequate serum levels of testosterone. But it is very important to establish the diagnosis of andropause after carefully ruling out other causes. For example, it has been observed that symptoms of andropause are often confused with other systemic diseases that may present with similar symptoms such as thyroid dysfunction. In addition, clinical diagnosis of andropause is also challenging because there is no cut-off normal value of testosterone in different age groups and within the same age group with different metabolic parameters (2).

What To Expect In Male Menopause?

The symptoms of andropause are primarily attributed to declining testosterone levels. The classic presentation of male menopause is characteristic for:

• Physical symptoms such as low energy, fatigue and overall weakness in the absence of any exertion
• Negative changes in the bone density (that makes you more vulnerable to injuries, fractures and other joint related issues)
• Psychological symptoms such as depression, anxiety, lack of motivation, poor self-esteem and poor concentration.
• Changes in the normal quality of sleep such as insomnia or difficulty sleeping
• Changes in the basal metabolism and accumulation of body fat
• Negative changes in the muscle mass and strength
• Negative changes in the size of testicles
• Gynecomastia (or development of male breasts)
• Sexual dysfunction that is marked by erectile dysfunction, low sex drive and libido
• Hot flashes
• Infertility

How To Manage The Symptoms Of Male Menopause?

In most cases, decline in testosterone is so gradual that most males don’t even feel a drastic change in their lifestyle and quality of life; however, certain personal and health related issues can greatly influence the presentation of andropause symptoms. In all such cases, it is always a good idea to speak to a healthcare professional to learn more about the most suitable treatment option, depending upon your indications and expectations.

• Testosterone replacement therapy: Since symptoms of male menopause are a result of testosterone deficiency, most healthcare professionals believes that testosterone replacement can help a great deal in restoring the normal quality of life. However, some studies links testosterone replacement with a higher risk of developing prostate cancer in men (2). There are a number of alternative options as well as such as bioidentical testosterone replacement and other hormonal analogues.
• You can also manage your sexual complaints by other methods such as drugs (sildenafil or phosphodiesterase inhibitors) and other similar agents.   
• Maintain a healthy stress-free lifestyle. Incorporate healthy habits and quality nutrients in your diet to maintain high energy levels and adequate physical as well as sexual stamina.

References

1. Matsumoto, A. M. (2002). Andropause clinical implications of the decline in serum testosterone levels with aging in men. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 57(2), M76-M99.

2. Brawer, M. K. (2004). Testosterone replacement in men with andropause: an overview. Reviews in urology, 6(Suppl 6), S9.

3. Stanworth, R. D., & Jones, T. H. (2008). Testosterone for the aging male; current evidence and recommended practice. Clinical interventions in aging, 3(1), 25.

4. Olarinoye, J. K., Adebisi, S. A., & Popoola, A. A. (2007). Andropause: an emerging world health problem. West African journal of medicine, 25(2), 84-87.