Male Menopause — does it exist?
All women will experience menopause at some stage in midlife. For around 95%, this will occur at sometime between age 45 to 55. But, over the past few decades, scientific evidence has emerged that a similar process occurs in most males. This has led to the term, andropause.
Basically, the peak of anyone’s life is age 30 and from that point on there is a slow but steady decline in all the body’s metabolic processes including our hormonal systems. This is also true for our reproductive hormones. For women, this is obvious through the loss of the normal menstrual cycle, along with many of the other symptoms that are common during this period of their life. Hot flushing, mood swings, irritability, depression and generalised aches and pains are very common during this time, with most women experiencing at least one of these symptoms during the course of menopause. But, many of the symptoms also occur in men.
The additional symptom that also occurs in men is a degree of erectile dysfunction. Thus, andropause may certainly be a difficult time for men, just as menopause is for women. But, apart from the obvious discomfort and annoyance of symptoms, are there any health consequences in the reduction in the male hormone testosterone?
A new study of 2,161 men 20 years and older examined the relationship between age, testosterone levels and a number of chronic conditions. The study particularly focused on nine chronic conditions including, cardiovascular disease, depression, hypertension, high cholesterol, high triglycerides, lung disease, stroke and type 2 diabetes.
The study divided men into three groups
Young men — 20 to 40 years old
Middle-aged men — 40–60 years old
Older men — age greater than 60
The study found that in young men and in the older men, those with low testosterone levels had a much stronger link to two or more chronic illnesses. The obvious question here is whether the chronic illnesses lead to low testosterone or whether the low testosterone actually contributed to the illnesses.
Over the past decade there has been a significant increase in various forms of testosterone therapy for males in this category. There are concerns that testosterone therapy may accelerate the growth of prostate cancer and some researchers have even linked higher testosterone levels to atherosclerosis (the progressive build-up of fat, inflammatory tissue and calcification in the walls of arteries leading to heart attack and stroke). But, other evidence points to the fact that testosterone therapy may improve metabolic syndrome (tendency to diabetes, high blood pressure, cholesterol abnormalities and abdominal fat) and thus possibly reduce the risk for a variety of conditions that can be linked to increased risk for cardiovascular disease and possibly even cancer.
As with most subjects in medicine there are often varying and opposing views and most conservative experts in the area would suggest caution in using therapies that do not have robust long-term data. But, many men suffer, typically in silence, from the symptoms of andropause and with the variety of testosterone therapies which typically involve weekly injections or testosterone implants or the more user friendly testosterone creams, many of the symptoms of andropause are well managed and markedly improve the person’s quality of life. My strong advice in this area is to have a proper and extensive medical workup before commencing any of these therapies.
Regardless, it certainly appears that reducing levels of testosterone as we age are of no benefit and, with proper monitoring and appropriate therapy, this may be managed with a very good end result.