Man-oh-pause

For decades, people in the medical profession have been squabbling about whether or not there is a male equivalent of the female menopause. Surely a quick survey of women living with guys in their 50s would have settled the debate in no time. The doctors would have discovered that there is little doubt that hormonal changes wreak havoc with the lives of a significant number of men from around that age.

It’s good to know then, that the idea that at least some of the “grumpy old men” out there have a valid medical gripe and aren’t just blaming a fictitious mid-life crisis for their outrageous behaviour is now gradually gaining scientific recognition.

A hormone slump

The male sex hormones that make you a man - by stimulating the formation of your sexual organs, the production of sperm cells in your testicles, the growth of your facial hair and by firing up your sex drive and giving you a deep voice and bulging muscles, etc. - are called androgens. They are produced in the adrenal glands and testicles. The most well-known is testosterone, but there are several others, including dehydroepiandrosterone (DHEA), androsterone and dihydrotestosterone (DHT).

Androgens are pumped into your body in a major fashion during puberty and typically reach their peak levels between 15 and 25. After the age of 30, testosterone levels start to drop by about 10 percent every decade as a natural part of aging. While most men retain healthy testosterone concentrations for many years thereafter, approximately 30 percent of them will feel some symptoms of the decline by the time they reach their late 40s and early 50s.

Man-oh-pause vs menopause

There are, of course, some important differences between what happens to women during menopause and what many men experience at about the same age. While menopause signals the complete shut down of a woman’s reproductive organs, men continue to produce sperm and are able to become fathers well into old age. Whereas menopause is quite an abrupt process, the changes in men tend to happen rather more gradually.

What’s in a name?

In men, the detrimental effects of low androgen levels are sometimes referred to as the “male menopause”, but the term “andropause” is more correct. You may also come across the following:

• androgen decline in the ageing male (ADAM),

• testosterone deficiency syndrome (TDS),

• late-onset hypogonadism (LOH),

• viropause, and

• irritable male syndrome (IMS).

Symptoms

Not all men will suffer from andropause and among those who do, the severity of the symptoms can vary greatly. There are a number of symptoms that have been linked to andropause, but since a drop in testosterone is also associated with a number of diseases, including diabetes, metabolic syndrome and Alzheimer’s disease, the exact relationship is still somewhat controversial.

Many of the symptoms of andropause are similar to those experienced by menopausal women, but tend to be much less intense:

• fatigue, weakness, lack of stamina, vitality and energy;

• aches and pains;

• diminished sex drive and ability to maintain a strong erection;

• bouts of impotence;

• depression, listlessness,

• confusion, indecisiveness, low self-confidence;

• night sweats, palpitations, hot flushes, excessive sweating;

• sleep difficulties

• inability to concentrate, impaired memory, decreased mental quickness;

• anger, grumpiness, sulking, frustration and anxiety;

• swollen or tender breasts (gynecomastia);

• loss of muscle tone, size and strength;

• hair loss;

• osteoporosis, and

• increased body fat.

Treatment

Here are some of the treatment options, doctors may prescribe for men who are faced with the effects of andropause:

• Testosterone replacement therapy (TRT) aims to raise your testosterone levels through injections, skin patches, capsules, implants, creams or gels. It has been shown to alleviate symptoms such as low libido, depression and fatigue in some men. TRT carries the potential risk of increased incidents of prostate cancer, heart and lung diseases, stroke and a suppression of testicular function.

• A low fat, high fibre diet. Certain foods are known to enhance testosterone production, including: celery, oysters, eggs, almonds, dairy products and essential fatty acids (e.g. from oily fish like salmon and sardines).

• Stress reduction measures and anti-depressant medication.

• A regular exercise programme.

A video about andropause

Think you might be suffering from andropause? Let Dr Andre Berger give you an overview in this informative YouTube clip and then consult your own doctor:

More info about andropause:

• Books about andropause

• Men and the mid-life slump

• Male menopause: more fact than myth

• Is testosterone killing you?

(Andreas Späth, Health24, December 2009)