Male menopause is a common term for andropause and
hypogonadism, but it is not the same as the hormonal
changes that women experience as they age. In
menopause, the hormone levels in women drop suddenly.
Women usually experience an 80% decrease in sex
hormones during their first year of menopause, triggering
hot flashes, mood swings, osteoporosis, and other
ailments. Male hormone levels, on the other hand, drop
gradually over the course of several years. Andropause is
the age-related changes that happen in a man's body, and
is controlled by the group of hormones called androgens.
When men experience a deficiency of these hormones, or
suffer from hypogonadism (the broad term for the lack of
sex hormone production), the onset of andropause is the
result. Andropause initiates physical, mental, and
emotional changes in men aged 50 and older.
The function of testosterone in the male body goes far
beyond libido, and it is a type of androgen. For men,
testosterone kickstarts the changes they experience
during puberty and supports their mental and physical
energy, bone and muscle mass retention, hyperarousal
(fight or flight response), and red blood cell and sperm
production. Other types of androgens, such as
androstenedione, dihydrotestosterone (DHT), and
dehydroepiandrosterone affect bone and muscle
development. Additionally, androgens are responsible for
typical characteristics in men, including facial and body
hair and voice change. When the volume of androgens
coursing throughout the body is either too low or too high,
health problems arise.
According to the Mayo Clinic, men's testosterone levels
drop one percent per year after the age of 30, and some
preexisting health conditions can exacerbate this number.
Andropause presents itself with a host of varying
symptoms:
● low energy
● depression or sadness
● decreased motivation
● lowered self-confidence
● difficulty concentrating
● insomnia or difficulty sleeping
● increased body fat
● reduced muscle mass and feelings of physical
weakness
● gynecomastia, or development of breasts
● decreased bone density
● erectile dysfunction
● hair loss
● infertility
● hot flashes
While not all men experience andropause, the NIH reports
that low testosterone affects 20% of men in their 60s,
30% of men in their 70s, and over 50% of men in their
80s. However, there is a chance that cases of andropause
are overlooked and underdiagnosed. This is due to three
main factors, including men's unwillingness to visit the
doctor, men's hesitation with being open with their doctor,
and doctors not being as thorough and attentive in their
appointments with men as they are with women.
When men do seek medical advice
, they are often given
fewer explanations for their ailing health and participate in
less discussion about high risk behaviors (such as smoking
and drinking), even though they are statistically more
likely to partake in these habits. Additionally, men are
more reluctant to schedule regular visits with their
doctors.
The Cleveland Clinic reports that nearly 60% of men don't
go to the doctor unless they present symptoms that they
can no longer ignore. Similarly, the Centers for Disease
Control and Prevention (CDC) report that women are
100% more likely to schedule preventative care
appointments. Men who do schedule regular doctor's visits
aren't always completely honest about the symptoms they
experience or the concerns that they have, due to
embarrassment, fear, or nonchalance. Lastly, men with
low androgen levels might not exhibit obvious symptoms
of the condition, or the symptoms present are sporadic
and nonspecific.
Thus, while only 3-7% of men are reported to suffer from
hypogonadism, there is a chance that the condition is
underdiagnosed. Andropause is the forebearer of ailments
in many aging men; however, depression, hypothyroidism,
chronic alcoholism, and use of medications such as
corticosteroids, cimetidine, spironolactone, digoxin, opioid
analgesics, antidepressants, and antifungal agents might
all create similar challenges in men, according to the NIH.
These issues must all be ruled out before an accurate
diagnosis is made.
Andropause is diagnosed via blood test and, unlike women
who are prescribed hormone replacement therapy (HRT)
to cope with menopause, its most common treatment is
healthy eating, exercise, adequate sleep, and stress
reduction. For men who are experiencing depression,
doctors may prescribe antidepressant medication and
therapy. Common comorbidities of andropause include
metabolic syndrome, diabetes, and cardiovascular
disorders. Therefore, lifestyle changes will help manage
these conditions as well. Male HRT is controversial because
synthetic testosterone may have dangerous side effects
that include the production of cancerous cells within the
prostate and cardiovascular complications, such as heart
attack and stroke. For some men, the benefits of HRT
outweigh the risks, but the decision ultimately rests
between patient and doctor.
Male quality of life throughout the aging process could be
vastly improved if the realities concerning men's health
were more transparent and talked about in the open.
Additionally, men should feel confident in the doctor's
office so that they receive comprehensive care. This is
achieved through the relay of information and education
by doctors and care providers, and cooperation and
honesty from the male patient. While men's health isn't
always a hot topic, the discussion is valuable and could
save the lives of fathers, sons, brothers, husbands, and
uncles.
PAGE 05 June Issue 2021