| |
Introduction
Male menopause is often called low-T, or its medical term andropause, late-onset hypogonadism which is a result of low testosterone (male sex hormone) levels in men. Testosterone levels declines with age however, not as rapid when compared with female counterparts.
The symptoms of the male menopause are less clear. Sexual dysfunction is a common complaint, but other nonspecific symptoms such as depression, mood swings, weight gain or fatigue, may be seen.
In 2006, the Endocrine Society guidelines for evidence-based therapy, testosterone replacement therapy in men have been issued. According to the guidelines for men who have no disease of the testes or pituitary gland, the experts recommend testosterone therapy for men with low serum testosterone levels (<200 ng / dL) and symptoms of androgen deficiency. The goal of therapy in these men, is to achieve testosterone levels of 300-400 ng / dL | |
| |
Symptoms of Andropause
The symptoms of andropause are similar to the experiences of women and can sometimes be overwhelming. However, the male menopause is not to all men, at least not with the same intensity.
Men aged 40-60 years’ experience some lethargy, depression, increased irritability, mood swings, hot flashes, insomnia, decreased libido, weakness, loss of both lean body mass and bone mass (making them susceptible to hip fractures) and difficulty in achieving and maintaining an erection (impotence).
For these people, this unexpected physical and psychological changes a major cause for concern or even crisis. Without an understanding partner, these problems can be a powerful combination of anxieties and doubts, which can lead to impotence and sexual frustration as a whole. | |
| |
Causes & Risk Factors of Andropause
Andropause can occur in males who are exposed to excessive female sex hormone (estrogen) eg at workplace such as pharmaceutical industry, plastics factories, near incinerators, and on farms that use pesticides.
Males who develop early andropause are suffering from diabetes, hypertension, and genetic disorders that produce hypogonadism like Klinefelter's (XXY syndrome), Wilson-Turner and Androgen insensitivity syndromes. | |
| |
Diagnosis of Andropause
A complete body workup is to be done to find the cause of low testosterone levels and before starting testosterone replacement therapy.
This includes hematocrit, lipid profile, cardiac function tests, liver function tests, measurement of PSA (Prostate Specific Antigen) and digital rectal examination followed transrectal ultrasound (TRUS). | |
| |
Treatment of Andropause
Testosterone replacement therapy (TRT) is the mainstay of treatment. However, it should be used only for severe complaints as serious side effects, including prostate cancer can occur due to excess testesterone.
Testosterone is available in various forms - oral, injectable, transdermal and implants. Oral administration is generally not recommended due to high risk of liver toxicity. Injectable testosterone is safe, but not maintained consistently in the blood and excess is converted to estrogens, which is counter-productive as it alters the testosterone- estrogen balance in the body. A significant improvement in symptoms can be expected with appropriate treatment.
More recently, patches, lozenges, creams and gels have been introduced. | |
| |
References
- Mahmoud A, Comhaire FH (2006). "Mechanisms of disease: late-onset hypogonadism". Nat Clin Pract Urol 3 (8): 430–8.
- Mooradian AD, Korenman SG (2006). "Management of the cardinal features of andropause". Am J Ther 13 (2): 145–60
- http://www.medicinenet.com/script/main/art.asp?articlekey=119561
- http://www.andropause.co.in/
| |