Andropause is more frequently known as male menopause. It is a gradual process affecting males during the ageing process. It is still a debatable topic among the medical fraternity whether or not men undergo anything similar to the female menopause. Male menopause relates to the changes undergone by the male owing to changing hormone levels as they age. Men do experience a decrease in testosterone levels with increasing age and many of them have symptoms such as fatigue, loss of libido and depression. However as in female menopause in which there is a cessation of reproduction, male menopause is not associated with loss of reproductive ability. Also female menopause is associated with a sudden decline in production of ovarian hormones however in male menopause the testes do not completely stop production of testosterone.
By the age of 50 to 55 years the blood testosterone levels are much lower than levels recorded ten years prior to that age. And as age advances the levels of testosterone in the blood becomes lower than pre pubertal levels.
Symptoms: Andropause does not affect all men and its intensity varies in all. The symptoms produced are fatigue, depression, nervousness, decreased memory, insomnia, loss of libido, mood changes, inability to concentrate, hot flushes, changes in hair growth and skin changes, joint pains, difficulties in attaining and sustaining erections, irritability and anger.
Causes: There are no confirmed causes yet known to cause male menopause. However testosterone deficiency and relative estrogen increase is the most probable cause. Few other possible causes are excessive alcohol consumption, smoking, poor diet, obesity, lack of exercise and psychological problems.
Diet and regimen: Few changes in diet and lifestyle are known to ease the symptoms of Andropause to some extent. Few of them include: a nutritious diet, low in fat and high fiber, exercise regularly, plenty of water and oral fluids, limit consumption of alcohol and caffeine, maintain regular sleep hours, avoid smoking and tobacco consumption.
Treatment: Testosterone Replacement Therapy (TRT) is a treatment option available nowadays. However it must be administered by Registered Medical Practitioners, considering the serious side effects of this therapy, since the risk of prostate cancer, hypercoagulability of blood and hepatotoxicity is increased. Thus case selection and supervision of treatment is of utmost importance. Only those cases which genuinely fit into the symptoms of Andropause must be considered for TRT. Prior to administration of the hormone, all patients should undergo a full health check up including tests like complete blood counts, lipid profile, liver function tests, prostate specific antigen (PSA), testosterone levels, cardiac check up and trans rectal ultrasound. These tests should be repeated regularly during the course of treatment in order to detect any derangement as early as possible. Testosterone is available in injectable as well as oral forms. Oral forms are not preferred by some physicians owing to the risk of hepatotoxicity. Injectable doses are preferable as it causes much less toxicity. Injectable Testosterone bypasses the liver and hence causes less hepatotoxicity as well.
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