Do men go through a change of life called “male menopause” like women?
Academically this is also called Andropause, with andro=male,
pause=stop mean stopping being a man? Does a man stop being a man or less of a man when he is in Andropause?
The academicians call Andropause hypogonadism or abnormally low testosterone occurring in middle age or older men along with a certain symptom complex. As men get older it is well known that their ability to produce testosterone decreases while male estrogen levels however increase. A number of my older male patients have higher estrogen levels than the same age post-menopausal women. Higher estrogen levels in men cause less bioactive testosterone to be available to vital tissues. Elevated estrogen levels in men send messages to certain brain centers to produce less stimulatory messages to the gonads (testes) and therefore testosterone production can decrease. Also the gonads (testicles) with aging usually have less capacity to make testosterone. If you use certain medicines or natural supplements you can decrease the conversion of testosterone to estrogen, which increases with aging, obesity and other conditions. Therefore, by decreasing male estrogen levels brain centers send more signals to the testes to increase testosterone production. I have had good success with my patients in using this novel technique to lower estrogen in order to increase testosterone production in middle aged and older men.
Have you ever noticed that older men look more like women as they age? Some have small “boobs”-breasts. I mean real breast tissue not fat tissues around the nipples. True breast tissue can grow in men. Some older men have slower beard growth and their sweat smells less “pungent-sharp”, which can be from a drop in testosterone levels.
How can you tell if a male is experiencing the Andropause-Male Menopause Syndrome or Hypogonadism?
It is estimated that over 2.5 million men in the USA suffer from this condition with abnormally low testosterone levels. Some of the features of the Andropause Syndrome are:
1.Decreased sex drive.
2.Decreased energy levels.
3.Decreased muscle strength or endurance.
4.Loss of height, weak bones.
5.Decreased enjoyment of life.
6.Being “grumpy”, irritable, nervous or sad.
7.Loss of self-confidence.
8.Less strong erections.
9.Difficulty to maintain strong erections during sexual intercourse.
10.Falling asleep after dinner.
11.Decreased work capacity.
12.Increased weight and waist size.
13.Increased emotionality-weepy.
If a man answers a YES to at least 3 to 4 of the above questions, he may be suffering from a low testosterone (T) level and may have the Andropause Syndrome. These men should go to their doctor and have their total, free and bio-available testosterone (T) and estrogen levels measured in the blood.
What constitutes a low testosterone level that needs therapy and what kind of therapy?
What are the side effects and safety concerns of testosterone (T) therapy?
Each laboratory has a certain number that is considered as a low testosterone (T) level. The free testosterone (T) or bio-available testosterone (T) must be low to accurately diagnose Hypogonadism and the Andropause Syndrome. The total testosterone (T) number usually is not enough.
A man can have a high total testosterone (T) and a very low free or bio-available T. Borderline low free or bio-T should be interpreted in the context of each patient’s symptom complex individually. I believe each male has his own unique T level to function at an optimum level. I have described in articles and lectures in the USA about my concept of the “Testosterone Insufficiency Syndrome”. What is enough testosterone (T) for one man may not be sufficient for another. Clinically I make judgments on how a man looks upon examination of his muscle tone, fat levels, beard growth, breast tissue, gonads (small or large and soft, or hard) and other masculine physical parameters to determine what kind of male hormone problem he has. After measuring testosterone levels, estrogen and other hormones I decide if the patient needs testosterone (T) therapy. I also decide whether is best to give T replacement therapy (TRT) in pulses or continuously. I may possibly lower estrogen levels if they are high to naturally increase testosterone (T) production. Testosterone (T) treatment choices in the USA are 2 types of transdermal gels you rub onto the skin (AndroGel and Testim) or T injections into muscle. In Europe they have different T preparations and a bigger variety of treatment choices. Generally I prefer T gels since they are easy to apply and do not produce the large T spikes and then low T levels you get with injectable T.
Why should men be treated with testosterone, if they are deficient?
Not only to make them feel and function better. Low T levels have been shown to increase risk of osteoporosis, heart disease, inflammation, diabetes, increased fat mass, decreased brain function, memory and depression. There is also a 3 times increased risk for cancer death reported recently associated with low testosterone.
What to watch for if using T therapy?
The prostate gland needs to be monitored every 3 to 4 months by a doctor with a rectal examination and blood testing (PSA test). T can increase prostate size but does not cause prostate cancer. If prostate cancer is present T can make it grow faster. The blood hematocrit needs to be checked since T stimulates red blood cell growth. Too much T used by young men can decrease fertility and sperm levels and other problems Unfortunately many young healthy men are using testosterone and other testosterone like steroid hormones for “cosmetic” or body building or for sports performance enhancement. The male breasts need to be examined for growth called gynecomastia and it is also possible for men to get breast cancer. I have had some male patients have surgery for excessive breast tissue to prevent cancer and also for cosmetic reasons.
TESTOSTERONE MYTHS
1.The more T the higher sexual drive: You only need a lower to normal T level (the testosterone (T) petrol tank needs to only read ¼ tank full) for sexual drive and function. More T does not make a male more sexually driven.
2.T and anger and rage: if young maladjusted men with personality disorders are given big doses of T they can get quickly angry and explosive. T given to older well-adjusted normal men makes them happier, confidant and more relaxed.
3.Higher T level can increase muscle mass: When petrol testosterone (T) tank is reading full, this is true. A male with a higher free T or bio-available T has a greater capacity to build muscle with training and a proper diet.
4.Testosterone and heart disease: It has been recently shown that low T levels are bad for the cardio-vascular system. Normal T levels are beneficial.
IN SUMMARY
Men can experience something similar to the female menopause-called the Male Andropause. It is subtle and occurs less dramatically than the female menopause. It has some features like the female menopause: fatigue, irritability, loss of sexual desire and function, loss of muscle, fat gain etc. Some men as they age develop some female characteristics as their estrogens go up and testosterone declines.