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Male Menopause: Myth or Reality?

Male menopause or andropause continues to baffle us whether it is really a true identity or a myth. Most of us may wonder why a member of the family starts becoming grumpier or having mood swings or depression that we always blame on “midlife crisis” either relating to female menopause or a “male menopause“.

Both men and women have their own sets of hormones that regulate the body functions over time. Any decline in the female hormones at a certain age (around 45) results in a constellation of symptoms that we call menopause.

In women, once ovulation stops, the level of female hormones drop in a relatively shorter timeframe. However in men, changes in hormones are somewhat different. Instead of a sudden drop in hormone level, the changes occur gradually and therefore the symptoms are more subtle. In fact there are some men that are not affected by the hormonal changes over their lifetime.

The level of testosterone (the male hormone) starts to decline after the age of 40 at a rate of around 1% per year. By the age of 80, about 50% of the men will have low testosterone although some men will be able to maintain their levels into old age.

The telltale signs
Most men will remain asymptomatic except for some symptoms that may be related to aging. To be sure if the patient’s symptoms are related to testosterone deficiency, the best test would be to get a serum testosterone level.

So what would be the typical symptoms of male menopause? The most common complaint that men will have is the loss of sexual desire and the loss of spontaneous erections. Hot flushes, the typical symptoms that women complain of may not be evident at all. Other non-specific symptoms like decreased energy or concentration, feeling moody and sad including problems of sleep can be attributed to testosterone deficiency. But almost always the symptoms are rather non-specific since these symptoms maybe related to the daily stresses in life.

In terms of physical appearance, male menopause can result in an increase in body fat with reduced muscle bulk. As a result men will complain of diminished physical or work performance overtime.

The treatment
Once a diagnosis of testosterone deficiency is made by history, physical examination, and the blood tests, then treatment is rather simple. Testosterone replacement therapy is available by injection and by mouth. However, testosterone replacement therapy continues to be controversial, as effects of treatment have not been shown to be uniformly effective. Plus the treatment has its own side effects to include prostate enlargement and heart disease. It is therefore important that prostate and heart evaluation be done before any treatment intervention is started.

Herbal supplements are not worth trying. Their effects have not been validated nor their side effects studied. It is therefore advised at the present time to shy away from taking any herbal supplements to alleviate the symptoms of male menopause.

So what do I advise my patients? The same advice I give to anyone else: eat right, stay active, and enjoy life! By eating right and staying active one is able to maintain a good outlook in life, and through daily activity one is able to maintain physical strength and endurance. And by doing so, one reduces the risk of the stressors in life that exacerbate the symptoms of andropause.

Take care of your health by living right!

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