Male Menopause – ADAM

The condition’ male menopause’ or ‘andropause’ is a concept that has been garnering significant awareness. Aging tends to take its toll on the testosterone levels leading to its gradual depletion with time leading to andropause. It is important to be able to segregate between male menopause symptoms that are merely part of the usual aging process or whether these symptoms need treatment.

This syndrome has been dubbed ADAM (androgen deficiency of the aging male) or andropause is normally typified by dip in sexuality and general energy levels. Female menopause wherein there is cessation of menses or periods is a common and relatively abrupt change, while in male menopause the changes occur in a rather slow pace due to which it is tricky to decipher.

The dip in testosterone levels in the testes, the HGH or Human Growth Hormone from the pituitary gland and androstenedione from the adrenal glands all occur consecutively. This plummet does not take place till sixty or seventy years in certain men while it happens earlier in others.

Male Menopause Causes:

• The rare form of acute andropause is caused due to viral infections like mumps, operative excision of or operative injury in the testes and the male reproductive tract, diseases that affect immunity and cause harm to the testes like variants of systemic lupus erythematosis, mild genetic anomalies that allow regular adult growth but cause premature testicular malfunction, vascular diseases like diabetes, chemotherapy and due to the atypical pituitary tumors.
• Usually in the fourth or fifth decade of life and at times even commencing in the initial thirties, there is a slow plummet of testosterone in the body, mostly occurring during the ages past 50 that could lead to an array of undesirable consequences on the male body leading to andropause. This second type of syndrome is more sinister and often mistaken with male mid-life crisis as it closely resembles depression in males during their midlife. Certain factors that contribute to this condition include binging drinking, smoking, hypertension, improper diet and dearth of any form of physical exercise, those on prescription/non-prescription medicines, inadequate circulation and psychosomatic issues.
• Also consecutive to this physiological alteration is the surge in the SHBG or Sex Binding Hormone Globulin. This hormone traps the free flowing testosterone thus making it inaccessible to the body’s tissues. A miniscule quantity of free testosterone thus remains for carrying out the task of the male hormone. The surge in the SHBG levels could be in reaction to certain conditions like medical-related disarrays, being exposed to other hormone types like phytoestrogens – estrogens originated from plants like soy and environment-associated, estrogen-similar compounds like pesticides, hormones employed in agribusiness for fattening animals and others. Certain data indicate that men having low-fat or vegan diets are seen to have decreased testosterone levels.

Male Menopause Symptoms:

During Andropause, there is a depletion of hormone levels of testosterone and dehydroepiandrosterone leading to the following symptoms:

• Sapped energy levels and sense of weariness.
• Low libido, sexual dysfunction.
• Depressive tendencies.
• Niggling aches, weakness and rigidity in joints and hands.
• Abdominal fat accumulation.
• Sterility.
• Brittle bones due to osteoporosis that raises the likelihood of fractures.
• Disturbed sleep patterns.
• Back pain.
• Impotence.
• Lowered muscle mass.
• Night sweating.
• Tetchiness and rage.
• Early aging.
• Variations in hair growth and skin texture and quality.
• Loss of hair in the underarms and genital region.
• Reduction in size of the sex organs.

Diagnosis & Tests:

The analysis is quite uncomplicated that involves the measurement of the levels of free testosterone in the blood or calculating the FAI or Free Androgen Index. The test must be ideally carried out in the morning as the testosterone levels change through the day. At times, low testosterone levels could be detected in the later part of the day because of innate daily rhythm.

There has been ensuing debate on which level of total blood testosterone is considered normal in men. The normal values of total blood testosterone must lie in the lower range of 250-400ng/dl. The normal free testosterone level must ideally lie between 300-1100ng/dl and the FAI lying between 70-100%. The signs of andropause start surfacing when FAI levels are lower than 50%.

Testosterone is measured in one of the varying ways namely total testosterone and free testosterone or bioavailable testosterone. The free or bioavailable testosterone levels offer more correct results of the actual amount of active testosterone in elderly men.

Male Menopause Treatment & Prevention:

The testosterone replacement therapy is often implied with no evident proof that it raises the chances of prostate cancer. Men having synthetic testosterone supplements must get their serum lipids cautiously analysed and re-diagnosed at regular periods. Employing innate form of testosterone is safer than the use of synthetic form. There are many men that need the transdermal means of employment.

Usually when any hormone is given, the gland that generally produces it stops functioning when the therapy ceases could be inconsistent. Those patients having marginal low levels of testosterone might be putting themselves through a long lasting treatment if they commence with testosterone replacement treatment.

Undoubtedly, testosterone administration in men in those having its deficit is bound to cause major improvement and symptoms seem to subside. Regrettably impotence does not seem to improve with testosterone therapy except in those men with chronic hormone deficits that comprise nearly 8-16%. There is no proof that testosterone administration in men with marginal low testosterone levels would have an improvement in sexual performance though the libido might improve.

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