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Man-opause


The uncomfortable hormonal change that women go through in midlife has a male equivalent.

By Ivan Olegario, M.D.

 
OCTOBER 2011 

More women may complain about growing old, but that does not mean it is not an issue for men—they just don’t talk about it in the open. The truth is that aging is as much an issue for them, or arguably even more so.

Men seem to become more devastated as old age confronts them. In the media, for example, people suffering from midlife crises are almost always portrayed as male. The plight of the aging man is exemplified by the character of Roger Murtaugh (portrayed by Danny Glover) from the Lethal Weapon series, who keeps complaining that he is too old for all the troubles that come his way. The character was again referenced in the sitcom How I Met Your Mother, when Ted Mosby made a “Murtaugh List” which enumerated things that someone is too old to do, such as get one’s ear pierced, eat an entire pizza in one sitting, put off going to the doctor or drink from a beer bong.

While various diseases can be attributed to the decline men go through as they age, especially when they hit their mid-50s, another condition may be the culprit: andropause, or male menopause.


ADAM’s plight

In women, menopause is characterized by the cessation of menstruation and shutdown of the reproductive system. This process occurs over only a few years.

Norwin Uy, M.D., a urologist at The Medical City, says andropause, or more appropriately called androgen deficiency in the aging male (ADAM), is caused by a decrease in the male sex hormone, testosterone. This is due to the diminishing function of the male gonads (testicles) that comes with normal aging. There is an estimated 10 percent decline in testosterone every decade of a man’s life, beginning at age 30.

Unlike menopause, andropause is not a complete and permanent shutting down of the reproductive system. A man in andropause can still father children, but it may not be an easy task. As Dr. Uy explains, a man in andropause may experience lower libido and difficulty having or maintaining an erection. But like a woman in menopause, men may also experience a decreased sense of well-being, depression, lack of motivation, sleep disturbances, hot flashes, increased body fat, decreased muscle and bone mass, and hair and skin changes.

“The age when andropause starts, as well as the rate and degree of decline of testosterone, varies among men,” Dr. Uy notes. Most experience changes in their 50s or 60s, with a more dramatic decline in their 70s.


Testosterone tumbling down

Testosterone is a naturally occurring hormone primarily secreted in the testicles. It plays a key role in the development of male reproductive organs (e.g., the testicles and the prostate gland, the production of sperm cells, as well as male secondary sexual characteristics like body hair). It is also responsible for the greater muscle and bone mass seen in men, so those with testosterone deficiency are more prone to osteoporosis.

Aside from effects on a man’s body, testosterone also has effects on a man’s mental well-being. It promotes mental and physical energy, drive, motivation, attention, memory and libido. As testosterone levels fall during andropause, most of these physical and psychological effects decline as well, leading to its tell-tale symptoms.

There are some experts who believe that there is no such thing as male menopause because men can continue to reproduce into old age. However, the relationship between age, lower testosterone levels, and the symptoms of andropause is strong. Dr. Uy highlights that although male menopause is more of a syndrome (a collection of symptoms) rather than a distinct disease, its presence should be recognized, diagnosed and treated accordingly to ensure the best quality of life even in old age.


Turning back time

While andropause is generally considered a normal part of aging, a man’s life does not have to slide with his decreasing hormones. Although treatment will not completely stop the process, it can slow it down and improve a person’s well-being.


For more information on andropause and available treatments, check out the October issue of HealthToday, out now in major newsstands and bookstores.







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