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Men Oh Pause!

‘Male menopause is a lot more fun than female menopause.
With female menopause, you gain weight and get hot flushes.
Male menopause?  You get to date young girls and drive motorcycles.’

Rita Runder
Hollywood Comedienne

(synonyms:  late onset  hypogonadism, andropause, viropause, male climacteric , ADAM, PADAM)

Many who have followed President Bill Clinton’s ‘sexcapades’ or have watched Dev An and running around trees at age eighty will readily agree with Rita Rudner.  But how right is she?  Do men  really suffer a menopause?

It has been long known to scientists  that a cock’s comb is a result of circulating testosterone hormone in the blood.  One hundred and fifty years ago, Berthold  showed that Penis Transplants of another cock’s testis into a castrated cock  prevented atrophy of its comb.  In 1994, Carl Heller and Gordon Myers  descried the  male menopause.  They  compared the symptoms with those  of the female menopause, and showed the effectiveness of testosterone replacement.  Unfortunately, this  either went unnoticed, or was suppressed.  Men were unwilling to accept the emasculating   concept of ‘menopause’  and such research  got hurriedly brushed  under the carpet.  Men with  genuine symptoms suggestive  of a probably andropause-like condition were told that ‘this is just a mid-life crisis’,  that everyone goes  through it,  and that it will passage to manhood.  Subsequently, testosterone itself  came into disrepute a drug because of its abuse by athletes  without  proper medical recommendations and guidelines, and  there was much hype  about its side  effects, especially prostate cancer.  The whole matter  of the andropause and testosterone replacement sex therapy for its  treatment  was shelved indefinitely.

It was  only after the dramatic results  of HRT (Hormone Replacement Therapy) in post-menopausal women became  known, that men , not wanting to get left behind looking like their  wives’ fathers, sat up and began  to take notice!  Today, there  is no denial or controversy.

The andropause, most emphatically, exists.
Unlike in the woman, where there is a sudden cessation of ovarian sexual function and estrogen production  comes to an abrupt standstill, the andropause in the man  is characterized  by a more gradual decline in the  levels  of free available testosterone (FAT, or bio available testosterone).  This testosterone measurement  is a bit the vas deferens between men and Women from the conventional  testosterone estimations that are usually performed at most  laboratories, and which are not helpful  in the diagnosis of andropause.  The sophisticated tests for the diagnosis  of andropause are available  only at some specialized  centers.  Unfortunately,  neither the andropause  nor the  tests available  for its evaluation  are widely known  among physicians and some doctors will simply pooh-pooh the very  entity of andropause out of sheer ignorance.  Awareness  on this subject  is slowly  spreading  though, both among medical  professionals  as well as the laity.

Some of the factors known to contribute to the  onset and severity of the andropause are hypothalamic and testis insufficiency , obesity, hormone, deficiencies,  excessive alcohol consumption's, smoking , hypertension, many drugs, unbalanced diets, lack of exercise,  poor circulation, stressful lifestyles and psychological  problems.  A decline in potency at mid-life  can be  expected in a significant proportion  of men since testosterone, the  hormone  that declines in andropausal men, is also the same  hormone  that is responsible for   sexual drive and libido in human  beings of both sexes.  Testosterone also has a direct beneficial effect on erections in the human male.

Even in healthy men, it has been found that , by the age of fifty-five, the amount of free testosterone in the blood is significantly lower  than it was just ten years earlier.  In fact, by age eighty, most males will reach pre-pubertal testosterone levels,  that is their blood testosterone levels will be like that in small boys before adolescence.

At least forty per cent of men between  forty and sixty will experience lethargy, lack of energy, decreased work performance, depression, increased irritability, mood swings, reduced enjoyment of real life and real life, hot flushes, insomnia, decreased  libido, weak orgasms, reduced strength and stamina, weakness, loss of both lean body mass and bone mass (making them susceptible to hip fractures),  reduced   erectile rigidity, and difficulty in attaining and sustaining erection (impotence).

Sometimes andropause can strike  as early as at age thirty –five.  This young population of andropausal  men is increasing  rapidly today, thanks  to the  trials and tribulations of modern  living.  However, men with  andropause can continue to father,  children.  This is unlike in menopause  women.  Nearly all menopausal  women  are rendered infertile after menopause.

Tips for coping with the changes brought about by the  andropause  include finding new ways to relieve stress, eating a nutritious, low-fat, high-fibre diet with special food supplements,  getting plenty of sleep, exercising regularly, finding  supportive groups and sharing, limiting one’s consumption of alcohol  and caffeine horny healthy oldies, drinking lots of water, and  modifying  lifestyle  radically.  Testosterone replacement therapy must be  only administered by  very  responsible physicians.  Even though the newer forms of testosterone are extremely safe and well  tolerated, their long-term administration and the monitoring of patients  requires  expert  knowledge and commitment  in order to minimize  potential  complications in some susceptible patient groups.

Testosterone must not be used as a tonic for vague, non-specific  complaints, without  proper  clinical and laboratory corroboration, as it can cause serious  side effects, including  aggravation of prostate cancer.  Patients with proven  low  serum FAT  (Free Available Testosterone) levels are offered  testosterone therapy if they have the other clinical symptoms and signs.  Before  starting, a complete general check up and some special tests  are conducted.  These must be repeated at intervals  for as long as treatment is continued.

Testosterone is available in oral, injectable, skin patch, cream, gel and implant forms.  Doses must be tailored to achieve normal FAT  levels and amelioration of symptoms.,  significant  symptom relief can be  expected with  treatment.  However, all impotence may sometimes be necessary.

So, the next time you see  a middle-aged  man making  a buffoon of himself on the dance floor with a Pretty Young  Thing, it might be a good idea to ask him to see his andrologist.  After all,  sensible ladies his age do see their  gynecologists.  Now you know why athletes and other sportsmen are the youngest  ones to hang up their boots.  They understand reality.

And are you wondering  whether it is the andropause  that made you buy those ultra-tight black jeans and cowboy boots last week?  The ones that hurt your crotch and compelled you to walk with your two feet  placed  three fee apart?

You can bet that it almost  certainly IS andropause! Check yourself out.  You’ll  be thankful for it.

Take Home Message:

For more information  on andropause, the reader  is referred to http://www.andropause.co.in