Talk:Andropause

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[edit] Expert help

Some expert help is needed with this article as to what extent male menopause is even recognized as a clinical entity. Also one editor has claimed that "Regardless of nomenclature, doctors agree that the loss of hormones can be a painful and often life-altering affliction, whether it is experienced by women or men." First off, this is a Wikipedia weasel phrase... plus I don't think that doctors agree with this statement. All the doctors I have talked to say that male menopause does not exist. Help please? Invertzoo (talk) 18:15, 16 December 2007 (UTC)

[edit] Neutrality

This article has problems with NPV, amongst other things. Invertzoo (talk) 15:17, 12 December 2007 (UTC)

[edit] Article Update

It's my first Wiki entry any feedback and edits appreciated. Especially regarding references... Going to mess with it more tomorrow. Cleaned up somebody esle's external refs as a bulleted list. Is this convention?

Hacel 19:24, 25 June 2007 (UTC)

Hi Hacel

I'm not an expert on Wiki either, but would like to mention some points regarding andropause.

One of the causes of Andropause is related to CYP19 (aromatase), from the books I've read it seems to be an important factor. Hypogonadism is well understood so I'm not going to mention it.

CYP19 [1] converts testosterone to estradiol, too much of this powerful estrogen vs unbound testosterone causes the syptoms of Andropause. Lots of books gloss over or don't even mention this relationship.

Normally a hormone called 4-OHAD keeps CYP19 low. [2]

4-OHAD is produced by the enzyme CYP3A4 acting on unbound Testosterone, which is a substrate for CYP3A4

The unbound testosterone only represents about 3% of total testosterone levels - the rest is bound to Albumin and SHBG (Source ISBN 0-07-145744-5)

There are many inhibitors of CYP3A4, many chemicals and some antibiotics inhibit CYP3A4, which in turn leads to a fall in production of 4-OHAD. The fall in production of 4-OHAD allows levels of CYP19 aromatase to rise, this in turn lowers the amount of testosterone available for conversion to 4-OHAD. This is a obviously a vicious circle.

Examples of antibiotics that inhibit CYP3A4 are erythromycin and tetracyclines (source ISBN 1-59195-089-9)

Sceptics of this Andropause theory ask why the hypothalmus doesn't sense low testosterone and instruct the pituitary to produce more LH (Luteinizing hormone). I can only call the following comments speculation because I've never seen any credible texts that detail this.

Due to the very similar chemical structures of estradiol and testoseterone, but the longer half life of estradiol over testosterone, the hypothalmic receptors get blocked with estradiol, I first read this in Eugene Shippen's book ISBN 0-87131-858-X He calls it androgen blockade. I consider his book to be credible, mainstream doctors don't consider anything credible that suggests that andropause exists.

My personal speculation is that even if androgen blockade does not exist that the hypothalmus just reads estradiol and testosterone as the same thing and therefore LH stays the same.

[edit] Information or Drug Companies?

The only Reference as of this note, http://www.e-juven8.com/male%20amdropause.asp, contains a lot of text from the first External Link, http://www.andropause.com, which seems to be one of those cleverly disguised pharmaceutical sites posing as an information site. Andropause.com seems to be pushing the drug Andriol. Despite the admitted fuzzy causation of andropause, the Diagnosis section and the subject of many of the links seems to suggest that hormonal replacement is the only option. Some authoritative "alternative" additions to this article would be more useful.

Yes, it's a classic cut-and-paste sign when you see pages of detailed information, yet no wikilinks. I personally don't care much for a wiki article that is just a copy of a reference. I mean, this is the internet, right? I say delete the copied text and let the article be without it. Rhetth 00:14, 7 February 2007 (UTC)
Ditto. I was going to post the same complaint. Other refs that might be more reliable:
http://www.andropause.org.uk/
http://www.wellnessmd.com/andropause.html
http://www.andropause.ca/en/index.asp
http://emas.obgyn.net/
Sundaybrunch 17:21, 1 April 2007 (UTC)

Seems to me that they should call it womanopause just to be fair. My guess is eventually all men go through it if they live long enough. First sign being erectile disfunction. No man wants to admit it. Not alot of statistics to prove it.

Working on this article bit by bit. If you notice my formatting errors, please let me know or fix them. Pretty new to wiki editing.

Hacel 19:26, 25 June 2007 (UTC)

[edit] Acupuncture, Chinese medicine, herbal treatments,

I, perhaps temporarily, moved this content on "Treatments" to ths page:

  • Acupuncture, Chinese medicine, herbal treatments,

The reason is that it is controversial, and I think a discussion of it is needed before displaying it, because such alternative medicine is doubted to have any positive effects. The facts are referenced, that is true, but the link didn't lead to any page where this certain information was found. Rather, it directed to an offering to buy a book, and it feels unnecessary to buy a whole book just to check for its references. Every such information ultimately needs references to experimental trials, but I couldn't find any such study, linking alternative medicine and andropause together when searching the NCBI databases. Perhaps I didn't search accurately enough. Perhaps that study wasn't puplished yet. Anyhow, if you want the claim republished in the article, please give me directions to any studies indicating the effectiveness of such effects. Mikael Häggström 13:45, 2 July 2007 (UTC)

[edit] Herbal Medicine

It is awkward to avoid copyright violation and create enough credibility in these pages, so I can't scan in and show the page in Lexicomp's drug, herb and cytochrome interaction handbook ISBN 1-59195-089-9 detailing St John's Wort as an inducer of CYP3A4 (it boosts the performance of the enzyme) but believe me it's there, perhaps someone can find an external credible web site to reference. It can be seen on the CYP3A4 page that St John's Wort is listed as an inducer (speeds up/boosts)

As many people know St John's wort is useful in treating depression, and it's no conincidence that men with andropause get depression. Current drugs like SSRI's and SNRI's effect the amount of neurotransmitters in the brain, thus treating the symptoms of depression.

St John's Wort and probably other herbs that haven't been tested yet treats (one of?) the cause(s) of depression by boosting CYP3A4 thus speeding up toxin removal from the body, and helping to boost 4-OHAD back to "normal levels", thus lowering CYP19 levels and boosting free testosterone levels.

Just for clarity I'm not saying that all causes of depression are caused by lack of free testosterone in the body, I don't know anything about other causes of depression.

Perhaps when we get a credible reference to put on the main page we can get Hacel's comment regarding herbs put back on the main page, not sure about the acupuncture comment however!



this article is completely unscientific--this looks like it was written by some self-help guru.