Male menopause is a term used to refer to an age-related decline in testosterone levels in men. However, male menopause is a misleading description because it suggests a comparison with the dramatic end of reproductive function in women.

All women experience a profound fall in estrogen levels at the time of the menopause. However, in men, testosterone levels fall much less and more gradually. This decline may not affect all men.

Other terms used to refer to a decline in testosterone levels include andropause or viropause. These terms have no established medical meaning.

Testosterone treatment is often not necessary
Testosterone treatment should not be endorsed, sought or prescribed as a ‘cure-all’ for symptoms of ageing. There is no evidence that testosterone treatment will benefit older men with slight falls in testosterone levels.

Only men with proven testosterone deficiency (also referred to as androgen deficiency) will benefit from testosterone treatment.

Diagnosis
Symptoms associated with a low testosterone level may include low energy, fatigue, poor concentration or memory, mood changes, low sex drive or loss of muscle strength. However, these symptoms occur in other conditions and are often not a good guide to a man’s testosterone level.

A diagnosis of androgen deficiency may be made only after an appropriate medical examination and blood tests to check hormone levels. Other tests may also be required, either to rule out other medical conditions or to identify causes (other than age) of the low testosterone level.

Illness may lead to a drop in testosterone levels
Many illnesses that are common in older men can cause a drop in testosterone levels. Illnesses that may cause either a drop in testosterone levels or symptoms similar to testosterone (androgen) deficiency include:

• Cardiovascular disease
• Some lung diseases
• Depression.

There is no evidence to support the use of testosterone therapy for these conditions.

Obesity is a major cause of reduced testosterone
Obesity is strongly associated with lower testosterone levels. However, this does not mean that obese men with lowered testosterone levels should automatically receive testosterone treatment.

Obese men with low testosterone levels should consult their doctor for a complete review of their health, lifestyle and physical activity levels.

Treatment for men with androgen deficiency
For older men (aged over 40) with proven androgen deficiency, a number of treatment options are available in Australia. The treatment prescribed can vary according to cost and what suits the individual person. The options include:

• Injections
• Implants
• Capsules
• Patches
• Gels
• Creams.

Men who are treated with testosterone will need to be regularly monitored by their doctor; this will include prostate checks as required according to their age and family history. Cholesterol levels should also be measured.

Things to remember

• The term male menopause is misleading.
• Testosterone levels gradually fall with age but the effects are variable.
• Symptoms may not be a good guide to testosterone levels.

Source: Better Health, Victoria Australia news network, 2008

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MaleSupport: NutriPlex Formulas 

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