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Other Names:
Male Menopause, PADAM Partial Androgen Deficiency in the Aging Male, Normal Male Reproductive Changes
Andropause

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Definition

Unlike women, who lose fertility suddenly and quickly, men become gradually infertile with aging through a slow decrease in testosterone production and changes in the reproductive system. This process known as Andropause (or male menopause) is a condition marked by declining androgen levels and may result from primary or secondary hypogonadism (a condition that results from the inability of the testes to produce the sex hormone testosterone, sperm or both) or it may result from a pathologic condition. Andropause is an inevitable effect of aging and half of the men over the age of 50 suffer from it. With aging, men experience a lower bone and muscle mass in the body and that can lead to other problems.

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Symptoms

Symptoms of male Andropause include erectile dysfunction (loss of ability to achieve and maintain an erection), lethargy (or feeling tired and out of energy), decreased libido and loss of interest in sex, insomnia or inability to get a good night of sleep, muscle weakness aches and pains, night sweats and hot flashes, anxiety and depression, thinning of bones or loss of bone and infertility.

The hallmark of Andropause is a marked reduction in fertility. In men that suffer from Andropause, sperm counts dramatically fall as production of sperm cells slows, making it less likely that an aging man experiencing andropause is able to father a child. Other common reproductive changes caused by andropause include a decrease in testicular mass and possible impotence (or erectile dysfunction).

The prostate gland may enlarge in andropause patients with healthy cells being replaced by scar tissue. This condition known as benign prostatic hypertrophy (BPH) will affect about half of all men who experience andropause. BPH may interfere with functions such as urination and ejaculation.

Mental and emotional changes are also very common. Libido may decrease and sexual responses may be slower and less intense than they were in a man’s youth. This is usually correlated to a decrease of testosterone in the body. The decrease in testosterone levels may be responsible for negative changes in a man’s mood and energy level, as well as hot flashes that are usually associated with menopause in women.

Decreases in bone and muscle mass associated with aging can affect self esteem. Aches and pains as well as fatigue and a decrease in physical strength are common amongst andropause sufferers. Frequently the loss of strength, sexual potency and energy, when combined with the lowered hormonal levels in an andropause patient leads to depression and irritability.

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Possible Causes

Andropause is caused by testosterone deficiency. Males with androgen deficiency have a low level of free and bio-available testosterone. The decrease in free form of testosterone causes the symptoms of andropause. Testosterone deficiency is not the most common cause of erectile dysfunction. A number of health conditions including diabetes, hypertension, atherosclerosis and use of certain medications can cause erectile dysfunction. Trauma to the genital areas and the overall health and health history of patient as well as his state of mood and mind will no doubt affect the likelihood and severity of andropause in the patient.

Andropause is a natural part of life just as menopause is for women. As people age, they lose muscle and bone mass, and levels of reproductive hormones begin to decline. These changes to the aging body affect other functions, leading to a variety of symptoms. There are known medical interventions that can help lessen the effects of and delay the arrival of andropause.

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Implications

Decreased satisfaction and frequency in a man’s sex life can cause friction within marriages and romantic relationships. Impotence can severely damage self esteem and confidence as can other symptoms of andropause, such as decreased strength and muscle mass.

Conceiving a child is difficult if a man is suffering from andropause. It is not impossible for an andropause patient to have a child because the body continues to produce sperm throughout its life, but the drastically decreased sperm counts can make conception extremely difficult. Note that not all men, even those undergoing andropause have difficulty fathering children. Men have been known to impregnate women well into their 70’s and 80’s. However, such cases are rare, and having a child at advanced age may require some medical intervention.

As we pointed out earlier, many men who suffer from andropause, also suffer from BHP. It is known that BPH may cause difficulty in urination by an enlarged prostate placing pressure on the urinary tract. This same action can prevent ejaculation. Both problems can potentially cause some pain and discomfort. Enlarged prostates are more susceptible to inflammation and infection as well. Complications can also arise if urine backs up from the bladder into the kidneys. This condition, known as vesicoureteral reflux, is serious and can cause kidney failure.

The risk of some cancers increases drastically in older men as well. Men over 40 have a very high chance of developing prostate cancer, and should have PSA (prostate-specific androgen) tests done at least once a year after they reach age 40. This blood test can be very effective in early detection of prostate cancer.

Impotence associated with andropause may be a sign of other underlying illnesses. Adult onset diabetes, hypertension and heart disease all cause impotence. Although not all cases of impotence are related to disease, a great many are warning signs of much more serious problems.

Diminished levels of testosterone are also risk factors for heart disease (especially arthrosclerosis- clogged arteries) and osteoporosis (loss of bone mass). Preventative measures in diet and lifestyle should be taken by men in order to compensate for this increased risk.

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Treatment

The medical treatment for andropause is hormone replacement therapy. This consists of supplementing testosterone to the body in order to compensate for the lowered production of the hormone. There are a wide variety of delivery systems for the medication; such as transdermal patches (worn on the scrotum), topical gels, creams, pills and injections.
Regular medical testing is required for aging men in order to monitor and detect the early signs of cancer (prostate cancer in particular), heart disease and diabetes, dyslipidemia, hepatotoxicity, and erythrocytosis.
Impotence can very effectively be treated by a number of drugs that have come onto the market in recent years. Viagra, Levitra and Cialis are three very well known brands that have rejuvenated the sexual happiness of countless older couples around the world. All have their own side effects.

Home Care and Natural Alternatives:
The hormone DHEA is effective as a natural alternative to hormone replacement therapy. DHEA is converted to testosterone in the body. However, DHEA should be avoided if you are already taking hormone replacement therapy.

Essential fatty acids found in a number of food and supplement sources such as fish oil decrease the binding of testosterone in the body, allowing more free testosterone to perform its functions.

One supplement that is essential for maintaining a man’s sexual functioning is zinc. This mineral is involved in almost every aspect of male reproduction, including testosterone metabolism, sperm formation and sperm motility.

Indole-3-carbinol is known to be helpful in decreasing a man’s risk of developing prostate cancer. It can be found in food sources such as broccoli, brussel sprouts and cabbage, or in more convenient supplement forms.

CoEnzyme Q10 is very helpful in the prevention of heart disease. It is also known to alleviate depression, increase energy levels and boost the immune system.

B vitamins are helpful in decreasing stress levels and preventing feelings of fatigue and weakness. They also help with circulation and are very heart-healthy.

Vitamin D3, Calcium and Magnesium are best taken combined in the aim of reducing the risk of osteoporosis. In combination they allow more calcium to absorb into the bones, and slow down the inevitable bone loss that comes with aging.

Saw Palmetto extract has been approved in a number of countries as a treatment for prostate problems. A number of studies have lauded its effectiveness.

Chrysin, Nettle Extract and Muria Puama are all botanical extracts that suppress estrogen in the body, and enhance free testosterone levels. They can be quite effective in counteracting the loss of libido that comes with andropause.

Exercise is the most effective way to keep muscle mass healthy and prevent bone loss. Regular exercise also increases testosterone production, and has even been shown to slow a large number of aging effects.

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Andropause