Andropause: The male menopause

It may come as a surprise or as a shock to the male chauvinists that like their female counterparts, males also attain menopause. In males it is actually not menopause, which literally means pause or cessation of menstruation; it is known as andropause or viropause or male climacteric and this physiological state is similar to menopause in females.

Nearing the age of 50 years, a male person may start feeling the first signs to suggest the onset of andropause. Though, age of onset and severity and perception varies from person to person.

In contrast to females, where the cessation of menstruation is the obvious signal for this physiological change, in males there is no definite sign-post and that defies easy recognition.

The physiological (natural) reasons for this transformation is the decreased levels of sex hormone, oestrogen in females and testosterone in males.

As a man reaches the age of 50, his testosterone level starts declining. This decline is gradual and may take years together to manifest its full effect.

This decrease in testosterone level and its manifestation resulting in andropause varies with the physiological and psychological state of the person, presence of any disease or infection, intake of alcohol or medicines, physical stress due to injury or any major surgery.

Andropause may cause a number of problems, significant ones being:

• Decreased libido resulting in lack of interest in sexual activities.

• Loss of muscle mass leading to decreased muscle power.

• Truncal obesity

• Psychological and behavioral changes affecting interpersonal and social relations.

• Loss of memory and concentration.

• Delayed reflexes and lack of alertness.

• Nervousness and irritability.

• Sleep disturbances.

• Decreased bone density resulting in back pain and fractures.

• Decreased circulation in the extremities.

Ignorance and lack of awareness about andropause results in non-diagnosis of the condition in a significant number of cases. The awareness of andropause is very poor both among common people and physicians; resulting in poor and delayed diagonisis.

Diagnosis

New and more sensitive blood testing methods are available in laboratories for estimation of bioavailable testosterone levels.

Treatment

Hormone replacement is one of the commonly available treatment to correct andropause. The drug dosage of 40 mgs per day can be taken in the form of capsules, injections or skin patches.

The effect is usually noticed after three to four weeks and the replacement therapy should be continued for a long time.

However, the medicine should only be started after a careful medical checkup to rule out the presence of any other medical problem. Blood testosterone levels should be checked regularly and the replacement therapy should be continued only till the levels are low.

Moreover, testosterone should not be used by the persons who have or had breast cancerdefine.

Similarly, the presence of any of the following conditions should caution a person from taking testosterone:

• Heart and circulation problem

• Enlarged prostate

• Kidney disease

• Diabetes mellitus

• Liver disease

• Edema

• History of allergy following the consumption of testosterone

• A bed ridden person

• A person who is on anticoagulants.