Andropause

The notions of virility and testosterone have always gone hand in hand. This male hormone is what makes boys and girls different. It drives the development of masculine characteristics during puberty. It makes men men. But as males reach middle age and muscles have a tendency to sag, so too, do testosterone levels. In fact, scientists are learning more and more about the effects of aging on testosterone levels, and the resulting impact this has on health. Some scientists and authors now believe that men's bodies experience a chemical change akin to menopause that is at least partly responsible for a variety of clinical symptoms and signs.

What is Andropause?
Andropause is the male menopause depicting the symptomatic decline in male sexual hormones in the aging male. It is also known as ADAM (Androgen Decline in the Aging Male) or PADAM (Partial Androgen Deficiency in the Aging Male).

By the age of 60, the male body produces two-thirds to one-half of the testosterone that it did at age 20. The result is a decrease in libido, reduced muscle mass and strength, reduction in bone mineral density, changes in mood and an increase in fat mass. While some call this "male menopause," this comparison isn't accurate. "The process of decreasing sex hormone secretion, is much more gradual, occurs later in life and may not affect all men.

Am I in andropause?

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What is the diagnostic evaluation?
To diagnose low testosterone, your doctor may look for warning signs in the medical history, physical examination, hormone (testosterone and other) level testing, and/or other tests.

What are the treatment options?
The treatment of low testosterone is either the direct testosterone replacement therapy or other medications that increase testosterone levels.

Testosterone replacement therapy
For years testosterone replacement was available in only two forms, oral drugs and injections, either of which had some problems. Oral testosterone could be toxic to the liver. Testosterone injections are more effective and safer, plus have the added advantage of being relatively inexpensive-but most people shy away from needles. This form of therapy also produces peaks and valleys in testosterone levels. After the intramuscular injection, the testosterone levels are above normal for a couple of days, then fall into the normal range for 5 to 7 days before returning to subnormal levels.

Transdermal testosterone patches met with limited success, because of potential of skin irritation. However, the recently introduced gel AndroGel has been become a very effective method of testosterone replacement therapy with good skin tolerability.

Testosterone replacement therapy is helpful for men suffering endocrine-related ED, but it also has several potential adverse effects-particularly exacerbating an already existing small prostate cancer.