Male menopause: Causes, symptoms and diagnosis

CHENNAI: Andropause or late-onset hypogonadism is a common disorder which increases in prevalence with advancing age. Diagnosis of late-onset of hypogonadism is based on presence of symptoms suggestive of testosterone deficiency - prominent among them are sexual symptoms like loss of libido, morning penile erection and erectile dysfunction; and demonstration of low testosterone levels.

We all know that women have a fixed ovarian reserve which gradually decreases over time, leading to menopause. Men don't go through menopause, but they face a similar problem as their testosterone levels tend to drop dramatically. Andropause is characterised by insidious onset and slow progression. Many names were given to this process like male menopause, male climacteric, androclise, androgen decline in ageing male (ADAM), ageing male syndrome, and of late, and late onset hypogonadism (LOH). True andropause exists only in those men who have lost testicular function, due to diseases or accidents, or in those with advanced prostate cancer subjected to surgical or medical castration.

What causes Andropause?

Testosterone is responsible for a variety of important functions in men. For example, it regulates libido, sperm production, and muscle mass. Testosterone is important for bone health and blood production. It is produced in the testes and adrenal glands.

As men tend to grow old, testosterone levels tend to drop, along with the ability to produce sperm. This leads to a condition called andropause. Andropause can begin around the age of 40 but it can begin earlier and continues till 70 years. There has been increasing discussions about andropause, but not all doctors and psychologists agree that there is male menopause because not all men experience it, and for those who do, they often do not express it.

What are the symptoms of andropause?

Fatigue, poor libido, and difficulties concentrating are just a few of the symptoms that might occur as a result of this reduction. Apart from these following are other signs and symptoms:

• Diminished mental acuity (poor concentration, depressed mood)

• Loss of strength and energy

• Gaining weight, losing muscle, and gaining fat.

• Depressed moods and/or a lack of zeal and enthusiasm.

• Irritability and Sweats or hot flushes

• Muscle aches and pains (feeling stiffness)

• Hands and feet that are cold and itching

• Sexual dysfunction and loss of height.

How can it be diagnosed and treated?

Men cope differently with andropause; it depends a lot on their personality. Unlike menopause in women, according to doctors, more research is needed on andropause, or male menopause, to fully understand it and determine what can be done to help men at this stage in their lives. However,

1) If you feel the above-mentioned symptom then that's your sign otherwise your doctor will likely do a blood test to measure your testosterone levels. If they are low, hormone replacement therapy (HRT) may be prescribed.

2) Eat a good diet: A healthy diet, which includes a balance of vegetables, fruits, meats, fish and dairy products

3) Be active: Engage in regular exercise, including aerobic, muscular and flexibility exercises

4) Regular health check-ups: Get regular health check-ups including cardiovascular, prostate and testicular cancer

5) Hormones: Check hormone levels as you get older. Generally, between 40 and 55 several important hormones in a man's body begin to decline

6) Reduce stress: Exercise and relaxation help to reduce stress, as does talking to your partner, friends and family about your problems

7) Intimacy: Although sex is still important as you go through male menopause, you will start to view sex as a part of a loving relationship which includes friendship, intimacy and sharing

8) Sleep: Get plenty of sleep