Andropause – Causes, Symptoms, Diagnosis, Treatment in India

Andropause or Male Menopause, a scant publicised condition, could be responsible for a variety of inexplicable symptoms in men over 40,

ANDROPAUSE IS…

I Andropause is a medical phenomenon, similar to female menopause, which can affect men between the ages of 40 and 55. “Unlike women, men do not have a clear-cut signpost such as the cessation of menstruation to mark this transition. This means that most men experience a variety of changes – physical and mental – yet cannot understand why they are taking place,” explains Dr Rajesh Taneja, consulting urologist, Pushpawati Singhania Research Institute, New Delhi.

With age, the production of testosterone (the principal male sex hormone or androgen) decreases. Lower levels of testosterone and its consequences cause andropause as men age. Recent international studies show that after 30, testosterone levels generally decrease by one to two per cent per year – although this decline can vary widely. “As an urologist, I have noticed that roughly over the last decade, almost 28 per cent of men suffer from symptoms of andropause in the age group of 52-89,” says Dr DN Reddy, founding member, Indian Andropause Society and consultant at Apollo Hospital, Chennai.

TESTOSTERONE IS…

I Testosterone is a hormone responsible for producing physical
characteristics of male puberty and maintaining the features typical of adult men. Testosterone is also very important for maintaining good health in many non-reproductive tissues. It is important for the growth of bones and muscles and stimulates the bone marrow to make red blood cells. Finally, testosterone affects the mood and certain aspects of mental ability. Essentially, testosterone is required for optimal health in men.

“Because the decline in hormonal levels is gradual, plus there is not much awareness about this condition even amongst the medical fraternity, very few males seek doctor’s help,” states Dr Reddy.

SYMPTOMS OF ANDROPAUSE

I Symptoms of andropause can vary from one man to the other. They may include lethargy or decreased energy, decreased libido or interest in sex, erectile dysfunction with loss of erection, irritability, muscle weakness and aches, inability to sleep, forgetfulness, hot flashes, night sweats, depression, infertility, abdominal obesity and thinning of bones or bone loss.

HOW IS ANDROPAUSE DIAGNOSED

I “Recognising the warning signs of low testosterone is an important step in helping aging men maintain their health,” says Dr John Morley, a gerontology professor and director of the geriatric medicine division at St. Louis University School of Medicine, USA. Andropause can be diagnosed by measuring the level of testosterone in the blood. A simple serum testosterone blood test performed first thing in the morning on an empty stomach is a good screening test for this condition. “The test is available at almost all pathology laboratories across the country and costs could range from Rs 100$ to Rs 200$, depending on the centre,” explains Dr Reddy.

TREATMENT

To treat andropause, doctors may advise the patient to undergo hormone replacement therapy. “Replacing testosterone can have a significant benefit, particularly in older men, with an improvement in general well-being, sex drive, sexual functions, muscle mass and strength and an increase in bone density,” Dr. Taneja states. There are now several alternatives available for testosterone replacement therapy in the form of skin patches and creams that can deliver testosterone into the blood in a non-invasive manner.

There are certain conditions in which testosterone replacement therapy should never be used. These include breast cancer in males and prostrate cancer. Men who suffer from some ailments like liver or heart disease, edema, enlarged prostate or diabetes must check with a doctor before taking the therapy.

PREVENTIVE CARE

I It is a fact that decline in testosterone levels with increasing age occurs in all men. However, according to doctors, some current studies suggest that smoking and high cholesterol levels may increase the risks of early andropause. Thus, one should quit smoking and target at better cholesterol levels to prevent an early onset of andropause. Regular exercise will also help maintain the muscle and bone mass. Stress and the ills of urbanisation are also supposed to be a contributing factor. Yoga and meditation are advised with the onset of middle age.