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Male Menopause (Andropause)

Menopause is not a term seen only in women ,we also have a term called Andropause (male menopause) used to describe a state of lowered androgen levels in men as a result of the aging process. Androgens are a group of hormones that includes testosterone.
At about the age of 40 many men begin to experience a change that is often referred to as a midlife change or, as is described above, a midlife crisis. Having a midlife crisis has to do with a man’s psychology rather than his physiology.
Testosterone is the hormone that stimulates sexual development in male children, and is responsible for the sexual drive in adult men.

Testosterone is also responsible for muscle and bone growth. It has been found that even in healthy men, by the age of 55, the amount of testosterone secreted into the bloodstream is significantly lower than that at age 45 and, by the age of about 80, most male hormone levels decrease to pre-puberty levels.
The term Androgen Decline in Aging Males (or ADAM) has been used to describe this phenomenon. It is often at this time that a man begins to question what has been driving or motivating him.
• Has he been following his dream or has he been a slave to his job or career?
• Has he made the best choice for a life partner?
• Is he happy?
• Does he know himself?
To complicate matters it is also at this time when a man comes face to face with the incremental loss of his youth and the vitality that he once had., he feels he is not as attractive to women anymore, he questions his sexual ability and his health may have finally caught up with him and his bad habits.

Symptoms
The symptoms of ADAM are non-specific and may include:
• alterations in the circulatory & nervous systems (hot flushes, sweating, insomnia & nervousness);
• changes in mood and mental function (anxiety, irritability, poor sleep, constant tiredness, poor short-term memory & low self-esteem);
• changes in virility (decreased physical energy, decreased muscle strength & inability to participate in sporting activities);
• diminished sexual function (reduced sex drive, poor erections & impaired ejaculation);
• changes in physical appearance (abdominal weight gain, loss of body hair, diminished muscle mass & loss of height); and
• changes in body metabolism & chemistry (increased LDL cholesterol, increased total body fat, osteoporosis & reduction in the red blood cells in the blood).

Effects of Male Menopause

  • It can cause men to become distracted, irritable, disorganized,
  • Dissatisfied and even depressed
  • Men often have loss of libido
  • Weight gain

-memory loss and fatigued more easily.

-Some men cope poorly by using drugs and alcohol.
-craving to feel younger and more virile, may seek the company and adoration of a younger woman.
Midlife is a time when a man’s earlier fantasies can begin to crumble. It is the steady drip of reality, the awareness sinking into his brain that he is passing his peak; that he is no longer the “kid

Male menopause does not affect all men the same way. Many men do not feel the intensity of symptoms that others do. Although the severity of these Andropausal symptoms may vary from man to man, the inevitability of aging and the decline of youth in all its glory have its impact on all men.

Treatment
.General advice
Your GP will advise you about modification of your lifestyle by finding new ways to relieve stress, eating a healthy diet, getting plenty of sleep, exercising regularly, limiting your intake of alcohol and stopping smoking. If your symptoms are particularly troublesome, and not helped by general measures, your GP may then consider hormone replacement.
.Testosterone-replacement therapy (TRT)
TRT should be considered, when symptoms are present .

Testosterone replacement therapy, strictly a medical solution, is typically suggested by urologists. This treatment, although often effective, may bring with it an increased risk of elevated (PSA) Prostate Specific Antigens levels in the blood (a blood test that indicates a man’s risk for prostate cancer) .
Therefore blood levels are usually checked often when using this treatment.
TRT should not be prescribed if you have certain medical problems,
• known breast cancer or high-risk (advanced) prostate cancer;
• hyperviscosity syndromes
• high red blood cell count (packed cell volume greater than 50%);
• untreated obstructive sleep apnoea;
• severe prostatic symptoms; or
• class III or IV heart failure.

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