Treatment of male menopause may offer help for some men
Updated: May 20, 2012 8:03AM
Menopause was once thought to be exclusively experienced by women. However, now researchers are recognizing a “male menopause” that can affect some men.
As they age, all women experience menopause along with its significant decline in estrogen. As men age, only some men will experience a “male menopause” marked by low testosterone levels.
The male menopause, known also as “andropause” or late onset-hypogonadism, can only be confirmed by a blood workup showing low testosterone levels. The primary symptoms that might alert the patient and physician to test for low testosterone are:
low energy levels
overall weakness or fatigue
European researchers have identified three physical symptoms that were prominent in men with low testosterone: difficulty in engaging in vigorous physical activity, inability to walk one kilometer, and inability to bend or stoop. Psychological symptoms can also be associated with male menopause, including feelings of sadness. But overall researchers emphasize that physical and psychological symptoms are not as strongly associated with low testosterone as sexual symptoms.
Lesser known symptoms which also can be associated with low testosterone include the following:
changes in sleep patterns such as sleep disturbances, insomnia or increased sleepiness
physical changes such as increased body fat; reduced muscle bulk, strength and endurance; and decreased bone density
swollen or tender breasts (gynecomastia) and loss of body hair
hot flashes (rarely)
Some young men may experience a few of the above symptoms but do not have low testosterone. Older men also may experience some symptoms typical of low testosterone but are not in “male menopause” with normal testosterone levels. Such patients may be affected by many other medical conditions including cardiac conditions, gastrointestinal complications or even diabetes. Low testosterone may be only one of the contributing factors to a myriad of presenting symptoms and each patient should be thoroughly evaluated on an individual basis.
The incidence of “male menopause” is still being assessed by researchers with some suggesting it affects only two percent of elderly men, as reported in The New England Journal of Medicine (June 17, 2010) on the results of the European Male Aging Study. However, experts have long known that subtle changes occur in the testes over time with levels gradually declining throughout adulthood – about 1 percent each year after age 30 on average. By age 70, the decrease in a man’s testosterone level can be as much as 50 percent.
Men who do have confirmed low testosterone blood levels can elect to be treated with testosterone replacement therapy. Those men who have been treated with testosterone replacement report higher energy levels, improved mood and better sexual function. Some researchers also believe it can help with improved memory. The treatment can carry some risks, especially for older men, so a thorough analysis of the risks and benefits should be discussed by each patient with his physician.
Testosterone replacement should not be confused with erectile dysfunction drugs that aare also used to aid men with sexual dysfunction but would not be helpful for non-sexual symptoms associated with “male menopause.”
Overall, many experts feel that “male menopause” is a natural part of the aging process that may not require treatment. But for some men with severely reduced levels of testosterone, treatment can bring an improved quality of life and should be an option for them.
Iffat Ahmed practices internal medicine at Adventist Health Partners in Countryside with offices relocating to Adventist La Grange Memorial Hospital in May. She also practices at Adventist Hinsdale Hospital.