[YOUR HEALTH] How to manage male menopause

Menopause continues to be a problem in the adult male. If you are suffering from decreased sex drive or inability to sustain erection, then you may be suffering from male menopause, otherwise known as Andropause.

You probably thought menopause was something women went through when they reached the age of 50, didn’t you? Well, apparently men go through it, too. But andropause, unlike the female menopause which is related to female reproductive function, affects male sexual function instead.

Other symptoms of andropause are erectile dysfunction, decreased libido, mood disturbance (including depression, irritability, feeling tired, loss of muscle size and strength), osteoporosis, increased body fat, difficulty with concentration, memory loss and difficulty sleeping.

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The word ‘andropause’ is formed by combining two Greek words – andro (male) and pause (stop).

Men suffering from andropause may well feel that their manliness has, indeed, stopped or declined. Although medical practitioners have studied andropause since the 1940s, it is still a controversy, and many men still deny its existence. However, it is becoming more widely accepted in the scientific world as something that does indeed happen to men as they age.

It is described by Jed Diamond, a California psychotherapist and author of Male Menopause, as “puberty in reverse.” This is because like puberty, andropause wreaks “hormonal, psychological, interpersonal, social, sexual and spiritual changes in ageing men, just as puberty does for teenage youths.”

According to researchers in the Department of Urology, Queens University, Kingston General Hospital, Ontario, Canada, andropause happens to one in 200 Canadian men. A study conducted in 2003 by Dr. A. Festus and others of the University of Ife in Nigeria, found that 44 per cent of men aged 30-70 suffer from erectile dysfunction; and out of these, eight per cent was severe and 36 per cent moderate.

Needless to say, the researchers found that the incidence of erectile dysfunction increased as men got older from 38.5 per cent for men aged 31-40 years to 64 per cent for the older age group of 61-79 years.

Of social significance is that the researchers found that most men deny the existence of andropause. Thirty-nine per cent regard it as a myth, while another 24 per cent attribute it to various non-scientific causes which they usually blame on their wives. They, therefore, use this excuse to look for younger partners, only to discover that the problem has not gone away.

They may stop looking for younger partners, but the denial of its existence and not realising that andropause has a medical foundation stops men from seeking appropriate medical help.

Andropause is due to changing hormone level in men which progressively declines with age. Andropause is characterised by loss of testosterone, the hormone that makes men act like men. Most men’s testosterone levels drop as they age. However, some men are affected more than others are. The rate of decline varies from individual to individual. The loss of testosterone, which can happen to men as young as 35, is gradual, with testosterone levels dropping by one per cent to 1.55 per cent annually, starting at about age 30.

Testosterone level drops by about 10 per cent every 10 years. At the same time, another hormone in the body, called Sex Binding Hormone Globulin, traps much of the testosterone that is still circulating around the system and makes it unavailable to the body’s tissues to make them function properly.

The testosterone that is remaining to assist the tissues to function as they should is called “bioavailable testosterone levels.” Every man experiences a decline of bioavailable testosterone, but some men’s levels dip lower than other men’s. It is estimated that 30 per cent of men in their 50s will have testosterone levels low enough to cause andropause symptoms.

Testosterone is one of the hormones forming the androgen panel or make hormones. According to World Health Organisation, total androgen levels, not just testosterone, also affect male andropause as these hormones decline as men age.

The WHO study found that androgen levels of men aged 70 were only 10 per cent of that of men of 25 years. For this reason, some have described andropause as ADAM (Androgen Deficiency of the Aging Male).

Unlike women, men do not have a clear-cut signpost such as the stopping of menstruation to tell them they are in andropause. Instead, it comes as a gradual and distressful decline in their sexuality and overall energy, with increasing moodiness. By the time most men are 40-45 years old or middle aged, they have experienced some symptoms of andropause, which range from energy loss to depression to sexual dysfunction.

The bodily changes occur gradually in men and may be accompanied by changes in attitude, moods, fatigue and a loss of energy, sex drive and physical agility. Muscle mass and bone density decreases; and just like women, men are prone to broken bones and osteoporosis.

- Oladapo Ashiru/PUNCH

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