Men in their middle age are increasingly becoming victims of what is now widely termed as 'Andropause'
The male biological clock has just ticked half a century and though some of you might be filled with feelings of accomplishment on hitting the silver note, a lot of you might also be feeling you're not half the man you used to be. A loosening of girth for some, a lack of libido for others and why, you may be even prone to frequent bouts of irritability. 'Men'opause is no longer the prerogative of the woman, and as if the prefix secured it's inevitability, men in their middle age are increasingly victims of what is now widely termed as 'andropause'. *What is andropause?* The term andropause, derived from Greek, quite literally means Andro – Man, Pause – Cessation. In Britain, the term is also referred to as viropause. However, Greek derivations and variations notwithstanding, endocrinologists widely believe that the condition is more aptly described as ADAM – Androgen Deficiency of the Aging Male, and quite simply, that is exactly what it is. A significant decrease in testosterone as men age or hypogonadism, when the gonads lack proper functioning, give rise to this condition that has become synonymous with male menopause, according to Dr Shashank Joshi, endocrinologist with Lilavati Hospital. *How is it different from female menopause?* As with estrogen levels in women, men too experience a drop in testosterone, as they turn older. In fact, the female relationship between the ovaries, estrogen, the brain, and the pituitary is exactly the same as the male relationship between the testis, testosterone, the brain, and the pituitary. The most prominent difference between the two being that for women, the cessation of periods between their 40s and 50s marks the beginning of menopause, while for men; it isn't something that easily quantified. The process in men is much more gradual as compared to women, the drop in testosterone levels starting as early as the age of thirty, and continuing at about one percent a year for the rest of a man's life. By the age of 80, most men's testosterone levels have decreased to pre-puberty levels. In fact, since the change is so slow and subtle, most men don't even recognize it. *What are the symptoms?* Every man is affected differently, but those who do have significantly low levels of testosterone may start to develop a loss of muscle mass and bone strength, increased body fat, decreased energy, loss of libido, erectile dysfunction, irritability and depression. Often androgen deficient men will suffer from osteoporosis and diabetes as well. According to Dr Joshi, about 50 per cent of men with diabetes or erectile dysfunction are found to be androgen deficient. Other symptoms include testicular shrinking, reduction in hair growth, loss of memory and concentration, insomnia, hot flashes, increased anxiety, fear and loss of confidence. *Diagnosis* Since the symptoms include a combination of physical, mental and chemical changes in the body, which may often be psychosomatic, correct diagnosis and treatment is imperative. A testosterone level test will primarily determine whether one is androgen deficient, coupled with the doctor's evaluation of existing symptoms. Testosterone tests should be done in the morning when levels are the highest and repeated at least once to ensure accuracy. Testosterone levels less than 200 nanograms per deciliter mean one is deficient. In the average man, linking testosterone levels to symptoms and predicting which men with low levels will benefit from treatment is tricky, for several reasons. There are often many conditions that can cause the symptoms associated with testosterone deficiency. Alcohol abuse, thyroid and other hormonal disorders, liver and kidney disease, heart failure and chronic lung disease can all cause similar symptoms. Similarly, depression can cause many of these symptoms in men with perfectly normal levels of testosterone. It is also common for andropause to be confused with male midlife psychological adjustment disorders, because it exactly mimics depression in midlife men. According to Dr H B Chandalia, endocrinologist with Jaslok hospital, one should also check for pituitary disease if one is suffering from such symptoms since often a disease of the pituitary gland may contribute to low testosterone levels. For correct diagnosis, it is also important that men disassociate their egos from their testicles and realize that this disorder exists and is no different from a thyroid disease or diabetes that can be treated. The current paradigm in medicine is that there is no biological basis for behavioural changes in midlife men so it is a subject that needs education and awareness. According to a study, approximately 408 million men suffer from andropause, with numbers rapidly increasing under modern day lifestyle pressures. *Treatment* In men with rare conditions of significantly low testosterone levels, testosterone replacement therapy can improve their symptoms. Testosterone supplements have been shown to have both positive and negative side effects. The positive benefits are that it makes a man's bones stronger and less prone to osteoporosis or bone fractures. Testosterone has also been shown to improve a man's cardiovascular health. For those who need therapy, Testosterone is available in three forms and the most commonly used is the injectable testosterone. The other two are scrotal patches and tablets. According to Dr Chandalia, in some cases the administering of prolactin drug can also relieve symptoms as it is known to increase hormone and pituitary levels. *Side effects of androgen replacement therapy* On the negative side, experts say they do not know the long-term consequences of testosterone replacement. One of the main concerns is the effect it may have on the prostate, because testosterone can enlarge it. Increased testosterone can also cause blood clots and liver dysfunction. In some cases, it may also lead to hair loss, and in the rare circumstance the testosterone can be partially changed to estrogen, which causes breast growth. Heart disease is another major concern since increasing male androgen levels would also increase serum cholesterol and serum LDL-cholesterol levels. In some cases, it can worsen sleep apnoea, a condition with unusual snoring and daytime sleepiness. In cases where symptoms are not largely physical, inclusion of exercise, dietary changes and stress reduction can play a major role. Often counselling helps relieve a lot of psychosomatic symptoms and promotes a general sense of well being. It is also found that treatment for depression and engaging oneself mentally, physically and spiritually can help relieve many symptoms of andropause during midlife. *Being prepared* Men are less equipped than women to deal with their share of 'menopause' for a lack of awareness about this condition and often a sense of denial attached to it. According to Dr Joshi, one needs to be aware of the condition and maintain vigilance for symptoms. Often lifestyle changes can help prepare and deal with the onset of male menopause. - As men grow older their muscle gets replaced with fat, therefore it is important to build a healthy muscle mass through exercise. Maintaining a healthy muscle mass, directly affects the maintenance of testosterone. - Eat healthy and include adequate Calcium and Vitamin D in your diet. It is also important to protect your prostate, which soy foods and tomatoes are found to help. - Adequate sleep is very important for hormonal health. - It is also found that men with an active and healthy sex life are found to be less prone to androgen deficiency. - Good communication with one's partner can also play a great role in dealing with andropause. Sharing of one's feelings with one's partner helps in the awareness and recognition of symptoms, as well as provides confidence is seeking treatment. - Society has conditioned men to constantly act macho without being necessarily sensitive to their body's needs. Awareness and sharing of information on this condition with peers can also be a great way of preparing for one's own encounter with it! -- ~--~---------~--~----~------------~-------~--~--- Connect your World with Us join Now - http://groups.yahoo.com/group/dimpill_gang/join Affiliated group from dimpill_gang for Only Adult Mails - http://groups.yahoo.com/group/fantazies/join Affiliated group from dimpill_gang for Only Health and Food Mails - http://groups.yahoo.com/group/Health_and_Gourmet/join -~----------~----~----~----~------~----~------~--~
