Male's menopause: myths and reality

"Male's menopause": myths and reality

Almost everyone has heard of female menopause, but the term "male menopause" is regarded by many people as a joke name for a complex of physical, hormonal, psychological, interpersonal, social, sexual and spiritual changes in the lives of men who have reached a certain age. In this article, we will talk about the nuances of this condition.

 "Male menopause" does exist and has a number of synonyms: age-related androgen deficiency, age-related hypogonadism, andropause. However, there is one significant difference from female menopause: female menopause means the complete extinction of a woman's ability to conceive a child, while in men it is extremely rare.

 The root of the "male menopause" problem is that in middle age there is a decrease in the production of male hormones - androgens - and an increase in the amount of sex hormone-binding globulin (SHBG). It is important to note that often a normal level of androgens does not indicate a deficiency at all. If the sex hormones are in a bound state with a protein - HSPG (the amount of which can be dramatically increased), they become "inactive" and can not fulfil their function.

These age-related changes begin at age 35 and older. After the age of 30, every ten years there is a 10% decrease in testosterone levels (1% per year). If a man is physically healthy, leads an active lifestyle and does not have bad habits, he does not even realise it. All age-related changes are mild and do not make themselves known, but this is a deceptive impression. This is just the tip of the iceberg, the essence of the problem remains hidden, masked by all sorts of manifestations.

The condition was first described in detail in 1944 by Heller and Myers, who identified the following symptoms occurring together or separately:

Sexual dysfunction

-  Decreased potency

-  Decreased libido (sexual desire)

-  Impaired ejaculation and orgasm

-  Infertility

Internal organ disorders

-  Increased body fat with decreased muscle mass and strength

-  Disorder of urination (nocturnal/frequent urges, weak stream)

-  Decrease in bone density

-  Feeling of general physical weakness

Psycho-emotional disorders

-  Decreased efficiency, rapid fatigue

-  Moral discomfort: inner tension, anxiety, despondency

-  Increased need for sleep in the presence of problems with falling asleep, insomnia

-  Decreased memory and concentration

-  Irritability: aggression, outbursts of anger over small things

Researchers found that the subjects had reduced testosterone levels, and that symptoms abated dramatically when the patients received testosterone hormone treatment.

Subsequently, a number of factors have been identified that can lead to a decrease in testosterone levels: taking certain medication forms, unbalanced diet, excessive alcohol consumption, internal organ diseases, lack of sleep, lack of sex, stress or having undergone surgery.

 The likelihood of detecting low Testosterone levels

 2.7 times more likely to be detected if you are overweight (Body Mass Index ≥ 25 kg/m2)

 2.1 times more likely in diabetes mellitus

 1.8 times higher in hypertension

1.2 times higher if age ≥ 65 years

To summarise, the expression "forewarned is forearmed" is directly related to preventing the effects of "male menopause". It is often the case that even a small increase in testosterone levels can solve the problem. Nevertheless, there are no standard andropause treatment schemes - the therapeutic course is selected strictly individually, taking into account the hormonal background of each patient. Timely laboratory confirmation of the onset of andropause gives reason to start treatment. To diagnose "male menopause", the following test are used:

Total testosterone is the main male sex hormone

Sex Hormone Binding Globulin (SHBG), a protein that "inactivates" testosterone and is required for the calculation of the Free Testosterone Index.

Luteinising hormone (LH) - stimulates testosterone production in the body 

Take a test to see if you are at risk for low androgen levels (answers as YES / NO):

1. Do you notice a decrease in libido / pleasure from sex?

2. Have you become less energetic?

3. Have you noticed a decrease in physical strength and/or stamina?

4. Have you experienced a decrease in height?

5. Do you note a decrease in "enjoyment of life"?

6. Have you become sad/irritable?

7. Do you notice a decrease in the quality of erections?

8. Have you noticed a decrease in your success in sports?

9. Do you fall asleep in the afternoon?

10. Have you experienced a decrease in your ability to work?

If you answered YES to question 1 and 7 or any three other questions, the risk is considered high.

Warning. Testosterone, SHBG and LH levels can be tested in any treatment room of the OLYMP СDL branches of laboratories