Andropause

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Andropause is a medical phenomenon, similar to the female menopause, that 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. Both, however, are distinguished by a drop in hormone levels--estrogen in women, testosterone in men. The bodily changes occur very gradually in men and may be accompanied by changes in attitudes and moods, fatigue, a loss of energy, sex drive and physical agility.

Studies show that this decline in testosterone can put men at risk for other health problems such as heart disease and weak bones.

Unlike menopause, which generally occurs in women during their mid-forties to mid-fifties, men's "transition" may be much more gradual and expand over many decades. Attitude, psychological stress, alcohol, injuries or surgery, medications, obesity and infections can contribute to its onset.

Although with age, a decline in testosterone levels will occur in virtually all men, there is no way of predicting who will experience andropausal symptoms of sufficient severity to seek medical help. Neither is it predictable at what age symptoms will occur in a particular individual. Each man's symptoms may also be different.

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[edit] History

Andropause was first described in medical literature in the 1940s, but our ability to diagnose it is relatively new. Sensitive diagnostic tests, unavailable until the past decade, allowed andropause to remain a topic of debate among endocrinologists and men's health professionals. The idea that men, as well as women, might be subject to sex hormone fluctuations in later life has been a difficult one for many to accept. Today, there is an increased interest among medical researchers in the physical and psychological changes brought by men's aging. Still, the research is incomplete and, while the facts of the condition seem self-evident to many, more investigation is required for universal acceptance to be justified.

[edit] Diagnosis and treatment

Andropause routinely escapes diagnosis because symptoms can be vague and can vary greatly among individuals. Furthermore, while the female analog of this life change has a distinctive and sudden onset, production of the male hormone begins to decline as early as age 30 and proceeds over the next three, four or five decades until death. While the creeping symptoms of andropause are often dismissed by both patients and professionals as "what happens as we age" some have begun to consider them as signs of a disease state of which premature aging is merely another symptom. A diagnosis of Hypogonadism (also seen in younger men) often serves as a gateway to consideration of the broader condition. Once the condition is discovered, it is a straightforward (although somewhat involved) process of replacing the missing testosterone by injection, locally applied hormone gel, trans-dermal patch or implanted cartridge. The complicating factor in male hormone replacement is found in the highly individual nature of what is considered normal. Any given man could function optimally at a blood level one-half to one-third of another. In hormone replacement more is not better since an excess of testosterone beyond a man's customary blood levels can have quite unpleasant and even dangerous effects. Medical supervision is a must.

[edit] Causes

In the normal functioning of the male hormonal system, the vast majority of testosterone is bound to either of two blood components which transport it around the body and help regulate its function. These compounds - Sex Hormone Binding Globulin and albumin - tie up a full 97 to 98 percent of testosterone making it unavailable to the body's tissues. The remaining 2-3% actually does the beneficial work and is known as "bioavailable" or free testosterone. Furthermore, the receptor sites where testosterone must bind to be effective can also be occupied by estradiol, an estrogen also found in the male body which increases with age and body weight. In older men, especially age 60 and beyond, it becomes common to see that the body just doesn't have enough testosterone that is needed to do all the work it is supposed to.

While the concept of "normal" testosterone levels remains subject to various interpretations, a man whose total blood serum testosterone levels fall below 350 nanograms per deciliter will very likely experience andropausal symptoms to include erectile dysfunction, loss of muscle mass, irritability, generalized fatigue and even problems with memory and cognition. Free Testosterone levels below 6.0 picograms per milliliter can also trigger symptoms. These symptoms can seriously interfere with quality of life and men over age 50 are increasingly seen in doctors offices complaining of "not being the man they used to be". Other longer-term risks of low testosterone are gradually coming to light. Testosterone plays a role in maintaining cardio-vascular health, prevention of bone thinning (osteoporosis) leading to low-impact hip fracture, and a variety of other body functions.

[edit] In popular fiction

In one episode of the television show King of the Hill, Hank Hill's wife secretly adds large amounts of artificial testosterone to his food and drinks, making him much more athletic, aggressive, and abrasive than he normally is. When he discovers this and stops taking it, he temporarily experiences the opposite effects until his body resumes the production of testosterone. In one episode of the television show Yes, Dear, Jimmy exhibits many of the symptoms associated with andropause.

[edit] See also

[edit] References

[edit] External links

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