Is male menopause real?
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Male menopause (sometimes called andropause) is a term that you see bandied around a lot in health circles - but the term isn’t scientifically accurate. Menopause relates to the time when a woman’s reproductive cycle stops, and since men don’t have cycles, they can’t have a menopause. So why do health professionals sometimes use it?
Generally speaking, the term male menopause is often used to describe a decline in testosterone levels in men, a condition more commonly known as ‘testosterone deficiency’. Testosterone, produced by the testes, is thought to peak in men in their twenties. An average healthy man will have a testosterone blood level anywhere between 300ng/dL to 1200ng/dL (nanograms per decilitre).
Testosterone deficiency therefore, is when a man experiences a drop in his testosterone levels to below this normal healthy range. In simple language, for whatever reason the testes just aren’t producing enough testosterone.
Why is low testosterone a concern?
Since testosterone helps regulate many important bodily processes in men, low testosterone levels have been associated with a whole range of adverse health conditions, such as loss of muscle mass and strength, loss of bone density, osteoporosis, weight gain, diabetes and breast development, among others.
Many men with low testosterone experience symptoms such as lethargy, fatigue, poor concentration, weight gain, lack of libido or memory loss, but these symptoms can be quite non-specific in that they overlap with symptoms of other illnesses and with the symptoms many men naturally experience with ageing.
In fact, these symptoms are so common that in many cases testosterone deficiency may not be diagnosed at all and many men may be missing out on the benefits of treatment.
Some symptoms of low testosterone (Source: Daily Health Post)
Why is it controversial?
Testosterone deficiency is a condition that affects one in two hundred men under sixty. Historical studies conducted in Massachusetts and Baltimore have shown that on average from the age of about thirty, men have about a one to two per cent decline in testosterone levels per year.
However, more recent studies from Australia have shown that some men never see a clinically significant drop in their testosterone levels as they age.
Indeed these later studies have shown that even some healthy older men in their eighties and nineties haven’t experienced any change in their testosterone levels – and what’s more, some even have testosterone levels like twenty or thirty-year-olds.
As a result of these differing findings, experts now debate whether the drop in testosterone levels seen in the historical studies are really due to ageing, or whether the low testosterone levels seen in some older men is simply an indication of poor health.
76% of respondents so far have voted YES & 24% NO. What's your vote?
What are reasons for low testosterone?
There are many reasons for testosterone deficiency. They are mostly due to diseases of the testes or of the pituitary or hypothalamus glands - the glands in the brain that send chemical messages to the testes to produce testosterone.
Some common causes are Klinefelter’s syndrome - a genetic disorder whereby a man is born with an extra X chromosome, undescended testes - when a boy’s testes don’t descend properly at birth, or because of trauma to the testes or infection of the testes - for instance after having the mumps.
Researchers say weight gain and obesity is another major reason for low testosterone in men and it’s this topic which is being hotly debated right now.
Obesity and testosterone: the chicken or the egg debate
Studies have shown that testosterone levels are lower in men with diabetes and in obese men.
According to Clinical Associate Professor Carolyn Allan, medical adviser at Andrology Australia, low testosterone levels are even being seen in younger men who are overweight and obese.
“Today with the obesity epidemic we are seeing men in their thirties with low testosterone as well,” says Allan.
“It doesn’t actually mean that they have a problem with testosterone, with their testes - it just means that just like their obesity leads to an increased risk of diabetes, high blood pressure and sleep apnoea, it also leads to an increased risk of low testosterone,” she adds.
What’s not fully understood is whether this low testosterone contributes to diabetes and obesity, or if low testosterone is just a marker of common risk factors associated with obesity and diabetes.
Regardless of whether one causes the other, Allan says the answer to the problem for men with weight problems is clear. “If you treat the obesity, you will treat the testosterone levels,” she says.
“So the take-home message for older men is this: if you look after your health, if you exercise, if you have a good diet, if you maintain your weight, there is absolutely no reason why you should see a reduction in your testosterone levels that will have any negative impact on your health,” says Allan.
Eating healthy, exercising and minimising stress can help prevent low testosterone
The good news for men with medically diagnosed testosterone deficiency is that it is a very treatable condition. It is commonly treated with Testosterone Replacement Therapy (TRT), which aims to supplement the body with the missing testosterone.
“There are a range of different options available to men, they range from tablets, testosterone patches, gels and lotions applied to the skin and also injections,” says Allan.
As for the myriad of supplements, vitamins and health foods on the market claiming to increase testosterone levels, Allan says “there is no evidence that any specific vitamins, supplements or foods will increase testosterone levels” but she recommends “a good diet and exercise involving aerobic exercise and also resistance training to increase muscle mass and to reduce fat.”
Partners of men can help by actively encouraging men to go and seek medical help and to live a healthy and active lifestyle. “It has been shown that if you improve your diabetes control, if you lose weight - if that’s the cause of your low testosterone levels – testosterone levels will come up,” Allan points out.
See your healthcare professional if you think you might have low testosterone
For men who suspect that they might have low testosterone levels Allan advises them to “go and see a GP and have the proper physical examinations and appropriate blood tests.”
If the testosterone levels are low, she recommends then finding out what the cause might be. “The question should be: is this a primary problem, or is this a reflection of other health conditions?”
“It’s only by investigating the issue further with health professionals that men will then be in the best position to make the positive health decision that’s right for them,” says Allan.
New Australian study recruiting now Professor Allan is currently involved in a new research project called T4DM that aims to see if testosterone treatment and changing lifestyle can prevent type-2 diabetes in men who have pre-diabetes and low testosterone levels.
The study is currently recruiting men between the ages of 50-74 in NSW, VIC, QLD, SA, or WA. To see if you are eligible to participate visit www.T4DM.org.au.
Have you or someone you loved experienced 'male menopause'?