Andropause

Male menopause (andropause) is when hormone levels, in particular testosterone, gradually decline with age.

Statin drugs may contribute to low testosterone by making less cholesterol available for hormone production.

Symptoms include a sense of being burned out, low mood, irritability, anxiety, joint pain, increased sweating, tiredness and sleep disturbance, impaired sexual potency, decreased libido, decreased strength, lean body mass and decreased beard growth.

The following is a questionnaire used by Doctors to detect testosterone deficiency:

  • Do you have a decrease in libido (sex drive)?
  • Do you have a lack of energy?
  • Do you have a decrease in strength and/or endurance?
  • Have you lost height?
  • Have you noticed a decreased enjoyment of life?
  • Are you sad and/or grumpy?
  • Are your erections less strong?
  • Have you noted a recent deterioration in your ability to play sports?
  • Are you falling asleep after dinner?
  • Has there been a recent deterioration in your work performance?

Studies have shown that andropause is associated with diabetes, metabolic syndrome, and also affects brain, heart and bone health. It is a risk factor for heart disease, high CRP and metabolic syndrome.

Conversely, high testosterone is associated with low mortality from cardiovascular disease and cancer.

Low serum testosterone levels are often associated with erectile dysfunction. However, erectile dysfunction is a complicated condition, and it is unlikely that testosterone treatment alone will help. The classic testosterone deficiency triad in men is:

  • Erectile dysfunction.
  • Metabolic syndrome, visceral obesity and/or diabetes.
  • Cardiovascular disease.

Diagnosing andropause is symptom based as well as testing for certain chemical levels in your blood. A clinical examination including prostate check and cardiovascular risk assessment is needed before treatment is started.

Testosterone replacement therapy forms the mainstay of treatment for andropause.  Managing levels of oestrogen, progesterone and DHEA are also important in the treatment of andropause.

More research is now showing that testosterone treatments do not increase the risk of prostate cancer. However, testosterone therapy mustn’t be used in patients who have prostate or breast cancer.

Generally testosterone therapy improves mood, cognitive function and prevents Alzheimer’s disease, stroke, heart failure and some abnormalities of cholesterol. Testosterone improves libido and erectile function (but not in everyone), reduces inflammation and improves metabolic syndrome.

For further advice and to arrange an appointment please call the Medical Clinic on 01243 771455.