Subtle symptoms may indicate male menopause

Menopause, or change of life – as women become too old to bear children – can frequently be an agonizing and stressful time. But did you know there is male menopause?

It’s one of the “most under-diagnosed” ailments among older men, according to Dr. Charles Cartwright of Urology Associates of Lake County, Florida. Cartwright is part of a group of central Florida urologists who have been trying to find new and better treatments for male menopause.

He has diagnosed and treated hundreds of cases in his practice. As men age, their production of testosterone drops off, which can lead to a decline in sexual drive or erectile quality.

But male menopause has effects other than sexual, Cartwright points out. For example, several studies in Europe have found that testosterone therapy provides an increase in mental processing ability. This would counteract one of the characteristics of male menopause, which can be a decrease in intellectual acuity.

An article published in the “American Foundation of Urologic Disease,” found that some of the traits of male menopause, or andropause, are quite similar to those suffered by women when their reproductive cycle ends.

In contrast to menopause symptoms in women, andropause progresses slowly and often may be seen by the unpracticed eye as an unavoidable and untreatable result of aging.

Similar to female menopause, male menopause can cause mood swings, depression and anger. Other symptoms of male menopause are decrease in intellectual acuity and spatial orientation, fatigue, decrease in lean body mass, an increase in fat, a decrease in muscle strength and a decrease in body hair. The traits need not all be present. But the combination may well point to male menopause. The problem can be detected in about 10 percent of men over age 60, the authors said.

Health problems affecting elders today – both men and women – in order of frequency are heart disease, cancer, respiratory conditions, Alzheimer’s disease and other dementia, arthritis and diabetes.

A large proportion of men with any of those diseases also will need urological treatment, the Urologic Disease Foundation predicted. And as the population of elder men increases, which is occurring at a rate faster than that of the U.S., we can expect to see more cases of male menopause across the United States.

Current treatment options, Dr. Cartwright explained, include skin patches and gels. Also mentioned are oral tablets and implanted slow-release pellets.

Unimed Pharmaceuticals, which makes Androgel, states that as many as 5 million American men may have testosterone levels below normal. And “only 5 percent of these men are currently treated.”

Injections of testosterone tend to provide uneven results. In contrast, Androgel, according to Cartwright, has the advantage of feeding testosterone into the blood at a steady pace. But it is more costly than testosterone shots. And Medicare doesn’t pay for any portion of its cost, as it does for injections.

Testosterone levels vary greatly among men. In general, however, older men tend to have lower testosterone levels than do younger men. Testosterone levels gradually decline throughout adulthood — about 1 percent a year after age 30 on average. By about age 70, the decrease in a man’s testosterone level can be as much as 50 percent, according to the Mayo Clinic.

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