Male menopause: Myth or reality?

Aging-related hormone changes in men, sometimes called male menopause are different from those in women. Hormone changes are a natural part of aging. Unlike the more dramatic reproductive hormone plunge that occurs in women during menopause, sex hormone changes in men occur gradually. Here is what to expect and what you can do about it.

Debunking the myth of male menopause

The term 'male menopause' is sometimes used to describe decreasing testosterone levels or a reduction in the bioavailability of testosterone related to aging. In women ovulation ends and hormone production falls during a relatively short period of time. In men, hormone production and testosterone bioavailability decline over a period of many years and the consequences are not necessarily clear.

So what is the best way to refer to so called male menopause? Many doctors use the term 'andropause' to describe aging-related hormone changes in men. Other terms include testosterone deficiency syndrome, androgen deficiency and late onset male hypogonadism. Testosterone levels vary greatly among men. In general, older men tend to have lower testosterone levels than younger men. Testosterone levels gradually decline throughout adulthood - about 1 percent a year after the age of 30 on an average.

Recognizing low testosterone levels

A blood test is the only way to diagnose a low testosterone level. Some men can have a lower than normal testosterone level without any signs or symptoms. For others low testosterone might cause:

Change in sexual function: This might include erectile dysfunction, reduced sexual desire, fewer spontaneous erections such as during sleep and, infertility.

Changes in sleep pattern: Sometimes low testosterone cause sleep disturbances such as insomnia or increased sleepiness.

Physical changes: Various physical changes are possible like obesity, reduced muscle bulk, decreased bone density, swollen or tender breasts (gynecomastia) and loss of body hair etc.

Emotional change: It might contribute to a decrease in motivation or self-confidence. You might feel sad or depressed, forgetfulness and difficulties in taking decision.

What to do

If you are experiencing signs and symptoms that might be the result of a low testosterone level, consult your doctor. He can evaluate possible causes for the way you feel and explain treatment options. You cannot boost your natural testosterone production, but these steps might help:

Be honest with your doctor: Work with your doctor to identify and treat any health issues that might be causing or contributing to your signs and symptoms - from medication side effects to erectile dysfunction and other sexual issues.

Make healthy lifestyle choices: Eat a healthy diet and include physical activity in your daily routine. Healthy lifestyle choices will help you maintain your strength. It can improve your mood and promote better sleep.

Seek help if you feel down: Depression can cause men to suppress their feelings and become more aggressive or irritable. Men also might try to self-medicate by abusing alcohol or other substances.

Be wary of herbal supplements: Herbal supplements have not been proved safe and effective for aging-related low testosterone. Some supplements might even be dangerous.

Treating aging-related low testosterone with testosterone replacement therapy is controversial. For some men testosterone therapy relieves bothersome signs and symptoms of testosterone deficiency. Testosterone replacement therapy might increase the risk of heart attack, prostate cancer or other health problems. If you feel whether testosterone treatments might be right for you, talk to your doctor to find the pros and cons.

The writer is an Assistant Professor of Medicine at Z H Sikder Women's Medical College & Hospital, Dhaka.