Andropause: Men’s Menopause And Its Many Mysteries

Yes, men, too, suffer menopause. Here are symptoms, treatments, tips, and all you need to know about andropause as given by an expert, Dr. Omotuyi Mebawondu, during the high-ranking Platforms Africa’s e-Discourse. Excerpts;

 

To the ordinary person, what is Menopause?

Females are born with all their eggs (oocytes) stored inside the ovaries. When a baby girl is born, the number of oocytes is between 1 and 2 million, and the number keeps decreasing by 10,000 each month before puberty.

When a girl reaches puberty, she has between 300,000-400,000 eggs. The ovaries also produce hormones responsible for menstruation and ovulation.

Menopause happens when the ovaries no longer release an egg every month and menstruation stops.

Menopause is a regular part of aging in women when it happens after the age of 40. But some women can go through menopause early due to some circumstances

You mentioned age 40, as the starting point of Menopause, can it happen earlier or be delayed?

Menopause before the age of 40 is called Premature Menopause.

A surgical procedure to remove ovaries can cause premature menopause, some diseases like cancer can also lead to such. Even some medical treatment can cause the ovaries not to function

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Do men also have anything like Menopause?

Men do actually have experiences or illness mimicking menopause, but strictly speaking cannot be defined as menopause.

This label is misleading because it suggests the symptoms are the result of a sudden drop in testosterone in middle age, similar to what occurs in the female menopause. This is not true.

Although testosterone levels fall as men age, the decline is steady at about 1% a year from around the age of 30 to 40, and this is unlikely to cause any problems in itself.

Stress, diabetes, excess alcohol, and midlife crisis can also produce these symptoms. In that case, it is not ages dependent or caused by drop in androgen level.

Some researchers instead associate the symptoms with a condition called Androgen Decline in the Aging Male (ADAM), or late-onset hypogonadism. This occurs naturally when the gonads, or organs that produce sex cells, begin to age and lose function.

The condition affects only 2.1 percent of males, while menopause is a natural part of female sexual development. This prevalence increases with age but is still not a standard step in male development.

A doctor will suggest a diagnosis of late-onset hypogonadism when a man demonstrates three sexual symptoms and has androgen levels lower than 11 nanomoles per liter (nmol).

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Strictly speaking ADAM is not Menopause.

What causes Andropause in Men?

The male sexual hormone is testosterone. A fall in the production of the hormone will lead to symptoms of hypogonadism like low sexual drive, reduced muscle mass, fatigue and accumulation of belly fats.

Testosterone is a sex hormone that plays important roles in the body. In men, it’s thought to regulate sex drive (libido), bone mass, fat distribution, muscle mass and strength, and the production of red blood cells and sperm. As one ages, the testosterone level reduces due to reduced production from the gonads or testicular cells. Testosterone production is at its highest during adolescence and early adulthood. It has the highest value at the age of 20-25 in adults and the lowest at the age of 65-70 years. With aging, T production begins to decrease gradually. After an average of 30-40 years, a decrease of 1% is observed in men.

The effects or manifestations of this are similar to Menopause in women, hence the tag as Male menopause or Andropause.

Is the Andropause condition across races? What are the symptoms?

A.D.A.M can happen across races. Once the level of androgens falls below some level, symptoms are experienced.

The varied signs and symptoms some people attribute to male menopause include:

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1. hot flashes
2. moodiness and irritability
3. fat build-up around the abdomen and the chest
4. loss of muscle mass
dry, thin skin, excessive sweating.

A study in the New England Journal of Medicine (NEJM) identifies the most common symptoms of male menopause as decreased libido, a lower frequency of morning erections, and erectile dysfunction.

The study lists other symptoms that include a loss of energy, an inability to walk more than 1 kilometer, or 0.62 miles, and difficulties completing strenuous physical tasks, such as running or lifting heavy objects.

Kneeling, bending, and stooping might also become more difficult.

Depression and fatigue might also set in as a result of the change in male hormone levels.

How can symptoms like low sex drive and weak erections be managed?

Low sex drive and weak erection are not caused by drop in testosterone level alone.

Other causes include:

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Chronic illnesses like Hypertension, diabetes, renal disease, liver diseases.

Lifestyle: smoking, alcohol, stress, loss of sleep, obesity.

Drugs like anabolic steroids, antihypertensive, ulcer medication, anticancer, antidepressants, antifungal and prostate drugs.

From the above, treatment of low sex drive will vary.

General lifestyle: cut alcohol, stay active, good sleep and balanced diets.

If you’re on any of the drugs listed above, consult your doctor for help.

Be careful with those vitamins and even testosterone as it may increase the risk of prostate cancer.

Hormone replacement therapy (HRT) may be considered in certain cases.

• Lifestyle modifications: Making positive lifestyle changes can significantly impact andropause symptoms. Regular exercise, a balanced diet rich in essential nutrients, stress reduction techniques, and adequate sleep can help improve energy levels, mood, and overall well-being.

Psychological support: Counseling or therapy may be beneficial for men dealing with emotional challenges associated with andropause.

• Medications for specific symptoms: Depending on the individual symptoms experienced during andropause, medications such as phosphodiesterase type 5 inhibitors (e.g., Viagra) may be prescribed to address erectile dysfunction, or antidepressants may be considered for mood-related concerns

How can wives help? What should women know about Andropause and how to help husbands manage it?

Partners should be incorporated into the care of Andropause patients.

1. Psychological support
2. Engagement and discussion
3. Visit to health care and supervision of therapy
4. Embracing other forms of sexual satisfaction like touching, cuddling, and foreplay
5. Supporting change in lifestyle

Can Andropause be avoided and what are some tips to manage it?

There are specific health challenges that can predispose to Andropause.

The most important thing is to watch out for symptoms.

Here are some tips to manage it

Hormone replacement therapy (HRT) may be considered in certain cases.

• Lifestyle modifications: Making positive lifestyle changes can significantly impact andropause symptoms. Regular exercise, a balanced diet rich in essential nutrients, stress reduction techniques, and adequate sleep can help improve energy levels, mood, and overall well-being.

Psychological support: Counseling or therapy may be beneficial for men dealing with emotional challenges associated with andropause.

• Medications for specific symptoms: Depending on the individual symptoms experienced during andropause, medications such as phosphodiesterase type 5 inhibitors (e.g., Viagra) may be prescribed to address erectile dysfunction, or antidepressants may be considered for mood-related concerns.

 

This edition of e-Discourse, a weekly event organised by Platforms Africa, a forum created by award-winning African journalist, Adeola Yusuf, is moderated by Accra, Ghana-based veteran journalist, Francis KOKUTSE

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