Male menopause?

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Male menopause! The signs, symptoms and what you can do about it. See what Dr. Paul Turek has to say about it.

Female menopause has been known for centuries, but it has only recently been discovered that males also go through a similar phenomenon.

Female menopause represents a well-defined period in a women's life in which female hormone production stops, often accompanied by hot flashes.

Men experience a similar type of 'menopause' as the production of the male sex hormone testosterone diminishes in their 70's. This "male menopause"- clinically known as andropause-is similar to, yet different from female menopause.

Although both changes are sex-hormone based, andropause is usually more gradual a process than is menopause and occurs later in a man's life than does menopause in a women's life.

What are the symptoms of andropause?

During menopause, a woman's reproductive hormone levels fluctuate and ultimately fall, and often dramatically. Andropause is typically less dramatic a process that actually begins in the mid 40's and continues, gradually, until testosterone production is low enough to cause symptoms, sometimes three decades later.

With the decline in testosterone, men can experience fatigue, muscle weakness, depression and erectile dysfunction. They may also experience lethargy, increased irritability, mood swings, insomnia, lower sex drive, loss of lean body mass and bone mass and anemia.

One complicating feature of andropause and its associated symptoms is that many of these symptoms may simply be due to advanced age alone and completely unrelated to lower testosterone levels. As such, there is active debate about which symptoms, if any, are specific to andropause.

How is male menopause diagnosed?

To make the diagnosis of andropause, doctors look for a symptom suggestive of the condition (see above) and a blood test to confirm that there is a low testosterone level. The doctor may order other diagnostic tests to rule out other medical problems that can produce similar symptoms.

What are other causes of andropause-like symptoms?

Although the causes of andropause have not been fully researched, some factors that may contribute to this condition are hormone deficiencies, excessive alcohol consumption, obesity, smoking, hypertension, medications, poor diet, lack of exercise, poor circulation, and psychological problems, notably mid-life depression.

Can andropause be treated?

Often andropause symptoms that are not associated with low testosterone levels can be treated with lifestyle changes, that include diet or exercise programs, by correcting medical problems such as thyroid disorders or diabetes, or with medications such as antidepressants.

With andropause symptoms associated with low testosterone, testosterone replacement therapy (TRT) can be considered. TRT is given only by physicians and offered under strict supervision.

A thorough check-up is also important to get before starting testosterone therapy, to rule out conditions such as prostate cancer and sleep apnea.

Risks of therapy include worsening prostate cancer, worsening urination issues, gain in water weight, excessively high blood counts and worsening sleep apnea, making regular follow-up with your doctor important while TRT is being given.

The St. Louis ADAM (Androgen Deficiency in the Aging Male) questionnaire asks for the following symptoms:

• Decrease in sex drive.
  
• Lack of energy.
  
• Decrease in strength and/or endurance.
  
• Lost height.
  
• Decreased "enjoyment of life."
  
• Sad and/or grumpy.
  
• Erections less strong.
  
• Deterioration in sports ability.
  
• Falling asleep after dinner.
  
• Decreased work performance.
• Night sweats and hot flashes
  

Men experiencing problems 1, 7, or a combination of any four or more might be candidates for replacement therapy. This symptom score, however, is only a rough set of guidelines and is not absolute.

Tips to cope:

• Relieve stress with exercise, yoga, massage or acupuncture.
  
• Eat a nutritious, low-fat, high-fiber diet.
  
• Get plenty of sleep.
  
• Find support with friends or other social groups and talk to them.
  
• Limit your consumption of alcohol and caffeine to less than 2 glasses/cups daily.
  
• Drink lots of water.
• Wear wicking pajamas to help with night sweats and the hot flash
  

About Dr. Paul Turek:

Dr. Paul Turek, who is a leading surgeon and former endowed chair professor at UCSF, is leading the charge to make men aware of the importance of paying attention to their reproductive health.

Research has shown (some of which is Dr. Turek's research at UCSF) that reproductive dysfunctions in men are early indicators of severe life threatening health issues like cancer and cardiovascular disease. Dr. Truek wants to make sure men are checked by a men's health specialist when they are having symptoms.