Andropause
What is Andropause?
By the time men are between the ages of 40 and 55, they can experience a phenomenon
similar to the female menopause, called andropause. Unlike women, men do not
have a clear-cut signpost such as the cessation of menstruation to mark this
transition. Both, however, are distinguished by a drop in hormone levels. Estrogen
in the female, testosterone in the male. The bodily changes occur very gradually
in men and may be accompanied by changes in attitudes and moods, fatigue, a loss
of energy, sex drive and physical agility.
What's
more, studies show that this decline in testosterone
can actually put one at risk for other health problems
like heart disease and weak bones. Since all this
happens at a time of life when many men begin to
question their values, accomplishments and direction
in life, it's often difficult to realise that the
changes occurring are related to more than just
external conditions.
A
gradual hormonal decline
Unlike menopause, which generally occurs in women during their mid-forties
to mid-fifties, men's "transition" may be much more gradual and expand
over many decades. Attitude, psychological stress, alcohol, injuries or surgery,
medications, obesity and infections can contribute to its onset.
Although with age, a decline in testosterone levels will occur in virtually
all men, there is no way of predicting who will experience andropausal symptoms
of sufficient severity to seek medical help. Neither is it predictable at what
age symptoms will occur in a particular individual. Each man's symptoms may
be also different.
Is
this a new phenomenon?
Yes and no. In fact, andropause was first described in medical literature in
the 1940's. So it's not really new. But, our ability to diagnose it properly
is. Sensitive tests for bioavailable testosterone weren't available until recently,
so andropause has gone through a long period where it was underdiagnosed and
undertreated. Now that men are living longer, there is heightened interest
in andropause and this will help to advance our approach to this important
life stage which was identified so long ago.
Increased diagnostic capability
Another
reason why andropause has been underdiagnosed over
the years is that symptoms can be vague and can
vary a lot among individuals. Some men find it
difficult to admit that there's even a problem.
And often physicians didn't always think of low-testosterone
levels as a possible culprit. So these factors
often led doctors to conclude that symptoms were
related to other medical conditions (i.e. depression)
or were simply related to ageing and often encouraged
their patients to accept that "they were no
longer spring chickens".
This
situation is changing. New blood testing methods
are available and there is an increased interest
in mens' ageing among medical researchers. So much
attention is being focused on andropause that major
efforts are underway to quickly share emerging
scientific information with the international medical
community.
Causes
Starting at about age 30, testosterone levels drop by about 10 percent every
decade. At the same time, another factor in the body called Sex Binding
Hormone Globulin, or SHBG, is increasing. SHBG traps much of the testosterone
that is still circulating and makes it unavailable to exert its effects
in the body's tissues. What's left over does the beneficial work and is
known as "bioavailable" testosterone.
Andropause is associated with low (bioavailable) testosterone levels. Every
man experiences a decline of bioavailable testosterone but some men's levels
dip lower than others. And when this happens these men can experience andropausal
symptoms.
These
symptoms can impact their quality of life and may
expose them to other, longer-term risks of low-testosterone.
It is estimated that 30 percent of men in their
50s will have testosterone levels low enough to
be causing symptoms or putting them at risk.
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