Is Male Menopause Real?

Low testosterone might be to blame for a sluggish sex drive, fatigue and erectile dysfunction.

You're tired and cranky, and your sex drive ain't what it used to be. You may even have some issues with erectile dysfunction. Could you be going through "the change?" Turns out, midlife hormonal fluctuations aren't just a "woman thing." Men can experience menopause, too - in the form of low testosterone.

Though the phrase male menopause -- also known as andropause or, as some have dubbed it,"men-opause" is a bit of a misnomer, the condition is real, says Robert Brannigan, a urologist at Northwestern Memorial Hospital and associate professor of urology at Northwestern University Feinberg School of Medicine.

What Is Low T?

Whereas women experience a sudden drop in hormones that signals a change in their ability to reproduce, with male menopause the result is a gradual decline in testosterone. Because it happens slowly (over a period of years), the symptoms of male menopause (e.g., fatigue, sluggish sex drive, irritability, depression, muscle loss, and erectile dysfunction) may be subtle and hard to detect.

Testosterone levels fall naturally as we age - on average, about 1% a year after age 30. That means that by the time you reach 70, your testosterone level may have dropped by half from its peak. Though aging is the main cause of Low T, other conditions and medications, such as testicular cancer, a scrotum injury, chemotherapy, radiation treatment, and mumps, are all possible culprits.

Is Male Menopause Common?

According to a study in the New England Journal of Medicine, male menopause is relatively rare, affecting only 2% of men over 40. Other stats show that 5% of all men (and nearly 20% after age 70) suffer from Low T. However, urologists, such as Steven Kaplan, director of the Iris Cantor Men's Health Center at NewYork-Presbyterian/Weill Cornell Medical Center, argue that numbers don't tell the whole story.

"To some degree, most men experience some manifestation of [male menopause] in the sense that, as we age, we're not the same in our 50s or 60s as we were in our 20s," Kaplan says. "There are a lot of different reasons for that, but hormonal balance is a piece of that. Some men are bothered by it and experience symptoms, and others are not."

While the New England Journal of Medicine study defined male menopause as low testosterone plus at least three sexual symptoms (e.g., erectile dysfunction, poor morning erection, low desire), Brannigan says symptoms can manifest themselves differently depending on the patient. "At the end of the day, every patient is individual and unique," he says. "If his testosterone level is low and he has symptoms, we treat it. We don't insist that he have ED."

If your sex drive has taken a nosedive, your apparatus isn't working the way it used to, your muscles have gone flabby, or you have no energy, you may want to have your testosterone levels checked with a blood test. Normal testosterone levels range between 300 to 1,200 ng/dl. Brannigan recommends testosterone replacement therapy for men with levels below 300.

"It's not a panacea, and I don't believe in wholesale screening of everyone, but I do believe there is a place for it," Brannigan says. "It's not the fountain of youth, but if you're suffering from Low T, hormone replacement therapy may restore some of the pep that you're accustomed to.

The Physiological Role of Testosterone in the Male Body.

The problem of declining fertility and potency particularly acute rises in our society today, because people are very intense hard life full of stress, the effects of environmental factors, it is all happening against the background of malnutrition, bad habits and physical inactivity. We can not ignore the effects of this for the sole reason that they accumulate slowly, silently creeping gradually deteriorating health.

Back in the mid-19th century, Charles Brown, Sekar, the great French scientist, he observed himself not only an increase in potency at the age of 75 years, but the telltale signs of a significant rejuvenation of the organism as a whole, it has emerged that after injecting extracts from the testes of monkeys. It was the beginning of a close examination of sex hormones in science, today it is these effects of testosterone are the subject of attention of gerontologists concerned with the problem of active longevity extension of humanity.

Science has long known about the hierarchy of the regulatory systems of the body: any disruption in the body begins with the brain: on the bark or the hypothalamic-pituitary region. The above mentioned negative factors directly affect the higher echelons of regulation.

Hence the limitation of any hormone replacement therapy: it makes an artificial shortage of substances and do not address the root cause of the problem occurred. A failure by reducing the potency and fertility begins with pituitary region: reduced secretion of luteinizing hormone, which controls the production of testosterone by the testes. Meanwhile, testosterone acts on the whole organism.

Let us examine the physiological role of testosterone.
Male sex hormones (androgens) to have a biological effect on almost all body tissues, initiating the processes of synthesis and construction. That is all androgens, including testosterone, is an anabolic hormone.

Thus, the main effects of testosterone are:
-Stimulation of genital organs and central nervous structures (the hypothalamus and pituitary glands) of male pattern;
-Stimulation of body hair distribution of male pattern;
-Stimulation of linear growth of the body, stimulating muscle development, the development of the larynx and thickening of the vocal cords;
-Stimulation of red blood cell formation and distribution of adipose tissue in male pattern;
-Stimulation of the formation of sperm cells with FSH and LH (pituitary) the entire process of sperm formation takes about 74 days, after which the sperm is transported through the epididymis to the urethra close within 12-21 days;
-To establish the male psyche and sexuality.


The secretion of testosterone is not constant, but occasionally, that is the cause of significant fluctuations in its level in the blood. Maximum secretion occurs between 2:00 and 6:00 o'clock in the morning, and the minimum - at about 13:00. In the body there are only 2% of circulating free testosterone. About 68% of testosterone are associated with the transport of blood protein albumin, and another 30% - with a specific binding globulin sex hormones.

In the peripheral tissues by the enzyme testosterone 5-alpha-reductase is converted to its active metabolite most - dihydrotestosterone.

Decomposes testosterone in the liver and through urine and bile excreted.
The normal level of testosterone in healthy men in the first half of the day is 12-40 nmol / l.

The testosterone level less than 10nmol / l probably testifies for the deficiency of the hormone. Border data (between 10-12 nmol / l) requires clarification and further examination.

Together with the definition of the level of free testosterone is usually necessary to determine the level of binding globulin sex hormones (SHBG).

The decision to undergo a course of anabolic steroids - it is always a very important decision. Absolute contraindications to the use of steroids are prostate cancer and breast cancer. This is due to the fact that these tumors are generally hormone-dependent, i.e., arising due to hormone imbalance in the body, and their high performance. Steroid use in such cases leads to a sharp deterioration and prognosis.

Aging Changes in the Male Reproductive System

Aging changes in the male reproductive system may include changes in testicular tissue, sperm production, and erectile function. These changes usually occur gradually.

Unlike women, men do not experience a major, rapid (over several months) change in fertility as they age (like menopause). Instead, changes occur gradually during a process that some people call andropause.

Aging changes in the male reproductive system occur primarily in the testes. Testicular tissue mass decreases and the level of the male sex hormone testosterone stays the same or decreases very slightly. There may be problems with erectile function. However, this is a general slowing, rather than a complete lack of function.

Fertility:

The tubes that carry sperm may become less elastic (a process called sclerosis). The testes continue to produce sperm, but the rate of sperm cell production slows. The epididymis, seminal vesicles, and prostate gland lose some of their surface cells but continue to produce the fluid that helps carry sperm.

Urinary function:

The prostate gland enlarges with age as some of the prostate tissue is replaced with a scarlike tissue. This condition, called benign prostatic hypertrophy (BPH), affects about 50% of men. This may cause problems with slowed urination, as well as with ejaculation.

In both men and women, reproductive system changes are closely related to changes in the urinary system.

EFFECT OF CHANGES

Fertility varies from man to man, and age is not a good predictor of male fertility. Prostate function is not closely related to fertility, and a man can father children even if his prostate gland has been removed. Some fairly old men can (and do) father children.

The volume of fluid ejaculated usually remains the same, but there are fewer living sperm in the fluid.

Decreases in the sex drive (libido) may occur in some men. Sexual responses may become slower and less intense. This may be related to decreased testosterone level, but it may also result from psychological or social changes related to aging (such as the lack of a willing partner), illness, chronic conditions, or medications.

Aging by itself does not prevent a man from being able to enjoy sexual relationships.

COMMON PROBLEMS

Erectile dysfunction (ED) may be a concern for aging men. It is normal for erections to occur less frequently than when a man was younger, and aging men often have less ability to experience repeated ejaculation. However, ED is most often the result of a medical or psychological problem rather than simple aging, and 90% of ED is believed to be of medical rather than psychological origin.

Medications (especially those used to treat hypertension and certain other conditions) can cause some men to be unable to develop or maintain enough of an erection for intercourse. Disorders such as diabetes can also cause ED.

Erectile dysfunction that is caused by medications or illness is often successfully treated. Talk to your primary health care provider or a urologist if you are concerned about this condition.

BPH may eventually interfere with urination. The enlarged prostate partially blocks the tube that drains the urinary bladder (urethra). Changes in the prostate gland make elderly men more likely to have urinary tract infections.

Backup of urine into the kidneys (vesicoureteral reflux) may develop if the bladder is not fully drained. If this is not treated, it can eventually lead to kidney failure.

Prostate gland infections or inflammation ( prostatitis) may also occur.

Prostate cancer becomes more common as men age. It is one of the most frequent causes of cancer death in men. Bladder cancer also becomes more common with age. Testicular cancers are possible, but these occur more often in younger men.

PREVENTION

Many physical age-related changes, such as prostate enlargement or testicular atrophy, are not preventable. Getting treatment for health disorders (such as high blood pressure and diabetes) that lead to changes in urinary and sexual health may prevent later problems with urinary and sexual function.

Changes in sexual response are most often related to factors other than simple aging. Older men are more likely to have good sex if they have continued to have sexual activity during middle age.