Andropause, or “male menopause”, is still a rarely used word in our society. The reason andropause has never been in the public spotlight is because most men who experience it, have been reluctant and unwilling to acknowledge its existence. But men are also hormonal! I don’t know why it should be so surprising that men are physiologically similar to women. Just like women, when men start aging, their hormones start to decline.
The term ‘male menopause’ was first used in 1944 to describe various complaints of aging men which at least partially mirrored the climacteric symptoms in women. Continuous research resulted in the evolution of opinions about the nature of these complaints, from the clinical syndrome, diagnosed with the use of disease-targeted questionnaires, to a well-defined clinical and biochemical syndrome, called andropause or late onset hypogonadism (LOH).
In particular, “Andras” in Greek means human male and “pause” in Greek a cessation; so literally “andropause” is defined as a syndrome characterized by low levels of testosterone and decline of general well-being in older men. Testosterone is the main hormone produced in the testicles. It starts declining at the age of 25. When bio-available testosterone levels are measured, 50% of healthy men over 50 years of age show testosterone levels below normal range.
This age-related decline in bioavailable testosterone is less sudden in onset than female menopause and has a slower progression, but just as severe in long term consequences! Testosterone is essential for health & wellbeing. Most important functions of testosterone are: prevents osteoporosis; increase muscle tone and strength; maintain muscle tropism; increase physical energy; increase libido; maintain a good sexual function; decrease subcutaneous fat; helps to regulate blood sugar; keeps cholesterol low; support the immune system; enhances oxygen uptake; help to protect against Alzheimer and other neurodegenerative diseases; improve cognitive function (attention, memory) and mood; improve self-confidence; maintain cardiovascular health; prevent artery-clogging (anti-atherogenic); vasodilator; decrease blood pressure; decrease insulin resistance.
Although symptoms may vary from person to person, common symptoms of men going through andropause include: low sex drive; difficulties getting erections or erections that are not as strong as usual; lack of energy; low mood or depression; anxiety; irritability and mood swings; loss of strength or muscle mass; hot flashes; disturbed sleep; poor concentration; memory loss; joint pains or stiffness; palpitation; headache; ear buzzing (tinnitus); numbness and tingling; weight gain; thinner, dry, wrinkled skin.
Complications associated with andropause include an increased risk of osteoporosis (loss of bone density); sarcopenia (less muscle); cardiovascular / stroke diseases (elevated cholesterol, high blood pressure, thrombosis, haemorrhage, anaemia); dyslipidaemia; high blood pressure; atherosclerosis; vascular stiffness; inflammatory substances in the blood (increased cytokines); depression; dementia (decreased memory, decreased intelligence); obesity (more fat); type 2-diabetes (hyperglycaemia, insulin resistance, metabolic syndrome); poor wound healing; cancer. But there’s no reason for this condition to get so many men down!
Doctors can easily diagnose low testosterone by investigating symptoms and by performing a simple blood test. The treatment for testosterone deficiency is Hormone Replacement Therapy (HRT). Finally, in the past decade, testosterone supplementation has entered the conventional world of prevention, wellness, integrative medicine, functional medicine, anti-aging medicine, anything you want to call prevention.
Testosterone has become one of the most widely prescribed medications in the USA, increasing five-fold according to 2011 data. This increase has resulted in the dramatic growth of the testosterone replacement therapy (TRT) sector of the pharmaceutical industry from US$18 million in the 1980s to US$1.6 billion in 2011 [Handelsman, 2013]. The reason is multifactorial, but can partly be attributed to the continued growth of the population over 65 years of age and a greater awareness of medical comorbidities more prevalent with age and associated with low testosterone. However, it has not yet moved into the mainstream of medicine or become a topic for dinner conversation the way menopause is.
“SUDDENLY, I’M NOT HALF THE MAN I USED TO BE…” IF THE WORDS TO THAT BEATLES SONG MAKE A LOT MORE SENSE TO YOU NOW THAN THEY DID WHEN YOU HEARD IT AS A TEENAGER, THERE MAY BE MORE TO YOUR NEW FOUND UNDERSTANDING THAN THE WISDOM OF YEARS.
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I wish you all the best,
Dr. Valeria Acampora