Male Menopause—
Fact or Fiction?
Josiah Nelson, MD
Urology
Western Wisconsin Urology
Eau Claire
To men experience menopause? In “doctor speak” the term is “andropause”, since men don’t menstruate. It is controversial whether or not “andropause” is real and how it really affects men. Here’s what we know:
• As we age, sexuality and hormone production changes.
• Certain disease processes, such as obesity and diabetes, can exacerbate these changes.
• While men do not go through a defined period where hormone production stops, they often have a slow decline in testosterone production. This lack of testosterone can affect mood, muscle tone, bone mass, sexuality and energy.
It’s all about testosterone
Testosterone is the male hormone that affects sexual
features and male development. Testosterone is measured to
check for andropause or other conditions such as hypogonadism
(low testosterone levels in men). Some people argue that andropause is not a specific entity or disease process like we see in women, but is simply in the spectrum of hypogonadism. Hypogonadism is often caused by lifestyle and medications. Being overweight, inactive, or on certain medications puts men at risk for low testosterone. However, some men have a more profound loss of testosterone as they age. Andropause describes this distinct biological change in the production of testosterone seen during mid-life. Men can produce testosterone and sperm throughout their lifetime. A significantly low testosterone associated with symptoms of fatigue, weakness, depression and sexual problems should be evaluated as both hypogonadism and andropause are treatable.
Many men experience a mid-life depressive episode. This happens for a variety of psycho-social reasons that may not be related to andropause, but certainly can be aggravated by it. The diagnosis is made through a clinic visit and simple blood tests. The testosterone cycle follows a patient’s wake-sleep cycle where it peaks in the morning and drops off in the evening. Testing is done by checking the morning testosterone and evaluating the patient’s symptoms and medical history. Symptoms of fatigue, depression, insomnia, loss of muscle mass, trouble with libido and erections as well as mood swings may indicate a loss of testosterone. Some physicians use a score sheet called the ADAM (Androgen Deficiency in the Aging Male) score to evaluate a patient’s risk.
The St. Louis ADAM (Androgen Deficiency in the Aging Male) questionnaire asks for the following symptoms:
- 1. Decrease in Sex Drive
- Lack of Energy
- Decrease in Strength and/or Endurance
- Lost Height
- Decreased “Enjoyment of Life”
- Sad and/or Grumpy
- Erections Less Strong
- Deterioration in Sports Ability
- Falling Asleep After Dinner
- Decreased Work Performance
Men experiencing Symptom #1, Symptom #7, or a combination of any four or more of these symptoms may be candidates for testosterone replacement therapy.
In conclusion, men have a variety of changes as they age; some
of the most difficult can be related to sexuality and hormonal disruption. It’s clear that the male hormone testosterone affects
men psychologically and physically. In certain men symptoms of fatigue, depression, insomnia, loss of muscle mass, trouble with libido and erections as well as mood swings can be treated with testosterone replacement. In other men changes in medication or lifestyle can improve these symptoms. A thorough evaluation can help identify risk factors and determine if treatment is appropriate.
To learn more about andropause, your testosterone level, or testosterone replacement therapy, contact your family doctor or Western Wisconsin Urology.
Dr. Nelson – Western Wisconsin Urology
For information or to schedule an appointment:
715.835.6548 | www.eauclaireurology.com
Dr. Nelson sees patients in Eau Claire, Black River Falls and Osceola.
