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The Andropause

The Andropause

The andropause is known by a variety of terms including the male menopause, androgen deficiency in the ageing male and late onset hypogonadism. It is far more common than generally thought; research has shown that around half of men over the age of 50 may have abnormally low levels of testosterone in their bloodstream.

The andropause is a condition manifested by a collection of symptoms in association with a low level of the male hormone, testosterone. Adequate testosterone levels are important in helping to maintain sexual interest and activity, healthy bones, muscle, body shape and state of mind. In addition testosterone is important in maintaining a healthy cardiovascular system and in part may protect against diabetes.

Generally in normal, healthy men, levels of testosterone in the bloodstream gradually fall after the age of 30. The decline may be more rapid in some men than others and may be accelerated by injury, illness and disease.

Symptoms

Symptoms are generally vague and usually develop and progress slowly. Men and their doctors therefore commonly attribute symptoms to ageing or stress.

Symptoms and clinical signs associated with low testosterone levels can be divided into three areas: sexual, psychological and those affecting the body in general (somatic).

Sexual - reduced sex drive and interest, poor erections, small, shrunken testicles.

Psychological - low or depressed mood, irritability, poor concentration and memory, fatigue and tiredness, sleep problems, passivity.

Somatic - weakness and loss of strength, reduced muscle mass, increased abdominal fat and girth, sweats and flushes, aching joints and muscles, dry skin, reduced body hair and beard growth.

Cause

Conditions affecting the testicles, which produce testosterone, or the controlling areas in the brain (the hypothalamus and pituitary gland), may result in deficient production and blood levels of testosterone. Some chronic diseases, medicines, drug and alcohol abuse and lifestyle factors have been associated with low testosterone levels.

Diagnosis

Men with symptoms of the andropause can be diagnosed using a simple blood test.

Treatment

It is important to understand what has caused testosterone deficiency as correcting some underlying conditions may reverse the situation without the need for testosterone treatment. If treatment is required, many testosterone preparations now exist and formulations include gels, patches, capsules, lozenges, injections and implants.

If there are no contraindications to treatment, the andropause can be managed with testosterone replacement therapy. Treatment aims to restore testosterone levels to normal and has been shown to increase muscle strength, improve bone composition and improve mood, sense of well-being and sexual functioning and desire. Improvements have also been seen in cholesterol and blood sugar levels and other coronary disease risk factors.

Although testosterone replacement therapy has not been shown to cause or induce prostate cancer, it may aggravate a pre-existing cancer and therefore it is important to exclude prostate cancer before starting treatment. This can be done by clinical examination and taking a blood sample to test for prostate specific antigen (PSA), a substance in the blood which can help to identify the presence of prostate cancer and other prostate disorders.

If testosterone replacement therapy is started, it is important to have regular follow-ups which should include checks on blood levels of testosterone, blood cell counts, PSA levels and prostate health.

No man suffering from the andropause is too old to start testosterone treatment and benefits to body and mind usually appear within a few weeks.