The male menopause is a controversial topic because unlike in the female type, men do not experience a sudden stoppage in the synthesis and production of testosterone, the main male hormone. While women are usually known to suffer a total seizure in the production of oestrogen and progesterone, it is not the case in men. Consequently, the medical community is still debating whether or not men actually go through a well-defined menopausal period, principally because such changes are gradual at the onset.
This is an important difference because there are reports of otherwise healthy male patients who report having a series of problems similar to those complained of by menopausal women. Therefore, it is clear that it is not only women that suffer from the effects of changing hormone levels in the body. Men also experience the effects of a decline in the levels of testosterone in the body as they age. However, the effects of conditions such as obesity, diabetes, certain cancers, certain medications and thyroid disease also play a profound role in causing these changes. The testes, unlike the ovaries in the woman, do not run out of the substances required to produce testosterone. Thus, a healthy male can still produce good quality sperm well into his 80s or even beyond.
The male menopause is called Andropause in parts of the English-speaking world but it is a term which for now is not recognised by the World Health Organisation as a disease entity. It is argued that it bears only a superficial resemblance to the female menopause, which is clearly a distinct condition. The relationship between the steady decline in the levels of circulating testosterone in elderly men, and the equally steady decrease in the number of cells within the testes is well documented. Because of this association, it is agreed that states of naturally occurring low male hormone levels do not bear any resemblance to the male menopause because those are inherited disorders, but the Andropause is not.
Consequently, there may be some accommodation in the future that would make it an equally recognised disease entity that is associated with ageing. Thus, while women are unable to continue reproduction as a result of the female menopause, males only experience a reduction in that ability and even suffer from occasional bouts of impotence.
As a result of disease, subtle changes can occur in the function of the male testes as early as 45 to 50 years of age. These changes may be more dramatic in some men after the age of 70, when the entire process may become even more dramatic. While some of the symptoms are very similar to those seen in the female, there are some which are evidently very obvious. They include the following;
1) Fatigue
2) Depression
3) Erectile dysfunction with a loss of libido
4) Weakness
5) Reduced sense of self-esteem
6) Nervousness
7) Impaired memory and confusion
Hot flushes
9) Inability to concentrate
10) Abnormal sweating.
These various symptoms, first described in 1944, were found to respond quickly and within a short time-span to the administration of replacement doses of testosterone. It has also now been found in association with Alzheimer’s disease, a degenerative brain disease. While the male menopause is speculated to begin from an average age of 40, the female menopause has an average age of onset of 51. Indeed, after the age of 30, the level of circulating testosterone declines by one per cent per annum, equating to 10 per cent every decade.
These are some of the reasons why proponents want it recognised formally as a distinct problem. Whichever way the health community decides in the next few years, it is clear that this is a problem. This is because it affects millions of men around the world in various ways. Also, there would be an increasing need to find solutions for the many confused and depressed middle-aged and elderly men who would require treatment for the associated problems that this deficiency status would bring about.
The diagnosis of the male menopause is potentially easier than in the female because once a thorough clerking and examination have been performed, blood tests should be obtained for the assay of the male hormone. That should confirm the diagnosis. Although formal treatment may as yet be unavailable in our part of the world because of many constraints, some doctors working in other parts of the globe report that men on testosterone supplementation have reported a reduction in their symptoms and their severity.
Exercise and changes in diet may also help in improving the entire well-being of such ageing males with problems as itemised above. The decision to take any form of treatment must be made with a doctor’s advice since the use of androgens like testosterone may also make some other conditions worse, like in cancer of the prostate. When it is administered concurrently with conditions such as diabetes, the control of the latter becomes more difficult. So, it must either be stopped completely or the dose must be reduced, while the dose of the diabetes medications is raised.
It is also known to induce certain changes in the liver with long-term use that could predispose the patient to having a liver cell cancer. Sometimes, therefore, what may seem to be the solution to one problem could give rise to another or several. This scenario typifies that dilemma very profoundly. And this remains the single most important reason why these medicines must be used with adequate supervision.
-punch
December 15, 2015, 01:00:37 PM