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"I'm
a 51 year old male and I've always heard
that women go through menopause... around
40 and 50. I consider myself educated but
I cannot recall if the subject of male
menopause exists... Can a man go through
some of the same symptoms... or is this
just my imagination? Last night was
strange... I was experiencing anxiety
attacks, rapid heart beat, and what may
have been taken as hot flashes..."
Bob
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Do
men experience a decline in hormones as they age? Or is
hormonal decline associated with aging strictly for women?
According to Robert S. Tan, MD, MBA the answer is yes. Men's
hormone levels do decline during a period of time called
Andropause. This week I asked Dr. Tan a few questions about
changes experienced by men and how we as women can help them
transition smoothly.
Dr.
Robert S. Tan is a renowned Geriatrician who has an interest
in Aging Andrology. He teaches at the University of Texas,
Houston and is also author of the book: The Andropause
Mystery: Unraveling Truths About The Male Menopause.
Q.
How
can women recognize Andropause in their partners?
A.
Men
are not spared from Menopause. The Andropause is the time in
a man's life when the hormones naturally decline. It can be
defined as "a change of life for males that may be expressed
in terms of a career change, divorce, or reordering of life.
It is associated with a decline in male hormone levels that
occurs during their late forties or early fifties." Many
have questioned whether the male menopause is more myth than
reality. In truth there is an undeniable hormonal decline as
one ages, and this in turn aggravates the aging
process.
Like
Menopause, men suffer from symptoms of the Andropause.
Between the ages of 50 to 70, some men report symptoms such
as erectile dysfunction (failure to achieve an erection),
general tiredness, mood changes, night sweats and sometimes
palpitations. Most men attribute erectile dysfunction to be
the most significant event of the Andropause. Apart from
erectile dysfunction, mood changes can take place too. Some
patients of mine have complained of nervousness,
irritability and even depression. Other patients undergoing
andropausal changes report the feelings of wanting to be
closer to family and friends. Men often focus too intently
on their career, money and power in their earlier life,
often neglecting family and friends. In the andropausal
years, men and take on a more "maternal" role, as if
transitioning to become more motherly than fatherly. They
become more concerned about their friends and family, as if
regretting their former attitudes. It is interesting that
many patients do not sense these changes in themselves, but
rather it is women that notice this and tells me that he is
undergoing "the menopause"!
In
andropausal men, night sweats and palpitations occur because
of an overactive autonomic system in response to falling
testosterone levels. It is important not to dismiss or
misdiagnose physiological changes related to the Andropause.
Q.
How can women get men to go to the
doctor?
A.
Research demonstrates that men by and large are less
likely to see a doctor for any reason. Part of it is because
the male psyche where a dependent role is not acceptable.
Generally speaking, men tend to focus less on health and
more on money, power and status. One strategy to get men to
see their doctor is actually to see a understanding and well
trained doctor together. Sometimes, the doctor can get a lot
more information interviewing couples together. At times,
the interviews should be held separately and staggering
consult times 30 minutes apart is prudent.
To
assess for hypogonadism, which is in part the clinical basis
of the Andropause, the doctor will check for the following
things in men:
- Loss
of hair in the armpits and axilla
- Shrinkage
of testicles
- Decreased
Libido or low sex drive
- Erectile
Dysfunction or Impotence
- Lethargy
or tiredness
- Depression
- Decreased
muscle strength
- Oligospermia
or low sperm count
- Decrease
bone density
Androgens
basically create "masculinity" and the loss of androgens
such as testosterone leads to physical changes. Women in
their post-menopausal years complain of dryness in their
vagina, skin and sometimes even a lowering of the pitch of
voice. The dryness in the vagina could result in dyspareunia
or pain on intercourse. In men, subtle changes occur in the
post-andropausal years. The once dashing looks are now
exchanged for something much less eye-catching. Hardened
muscle disappears and instead, flabby fat accumulates, as
one gets older. This distorts the physique from an athletic
"android" to one with a beer belly and little muscle. The
skin also gets dry, and there is hair loss. Hair loss occurs
not only in the scalp, but also in the genital area as well
as in the axilla. The testes also atrophy (get smaller)
slowly. There is loss of height because of osteoporosis and
the spine gets curved from wedge compression fractures. It
is important to realize that testosterone can maintain bone
integrity just like estrogens in women.
Q.
What can women do to help their men make a smooth
transition?
In my
book, The Andropause Mystery, I described Six
Simple Strategies to Combat Stress in the Andropause. I
believe that if women can help their men use these 6
strategies; they would be on their way to a better and
complete life together. As the older male ages and undergoes
the Andropause, he has to grapple with profound changes and
issues. These changes bring about stress, and if stress is
not managed well, it can be very disabling and even lead to
depression. The 6 strategies for a successful Andropause are
summarized below:
- Teach
Men to Love and Reward themselves and others. Much
satisfaction can be obtained from not only receiving but
also giving. There comes a point in life where leaving
legacies behind become important.
- Teach
Men to Control and Organize themselves. In
particular, they should learn not to abuse
alcohol
and quit
smoking.
Time management is crucial as well.
- Teach
Men not to neglect Exercise. A combination of
cardiovascular and muscle conditioning will help delay
aging processes.
- Teach
Men to Relax and Rest well. The body is changing with
aging and there are physiological changes occurring and
that he and you should be mindful of that.
- Teach
Men to Feed themselves- not quantitatively but
qualitatively! It is important to eat the right kinds of
food to adjust for physiological aging changes.
- Teach
Men to Enjoy Aging and the Andropause. Some things
are inevitable, no matter what we do! It is important to
be satisfied. Most of us will have to pass through this
journey so let us make the best of it. May we make this
journey of profound change one also of positive
evolvement, and a time of rich blessings for ourselves as
well as those around us, as we age graciously through the
Andropause!
Q.
Do you think that the future for men's health will
commonly include hormone replacement as it is for women
today?
A.
I
studied 302 men, and one of the questions are asked them was
this: "if the doctor told you that your testosterone level
is normal, will you still go want testosterone replacement?"
Rather surprisingly, the majority of the respondents said
"YES". My rationale is that there really cannot be too much
of a good thing! Perhaps men perceive hormones like
testosterone differently from women. It seems to me that by
and large, men want to remain virile and stay away from
aging naturally. While some women have delayed the end of
reproductive life by the aid of science, it is rare.
However, men throughout centuries and across all cultures
have taken all sorts of supplements including aphrodisiacs,
secretogues, vitamins etc. in an attempt to stay virile. It
is interesting that some cultures in Asia have been using
the root of a plant for ant-aging purposes. Recently,
scientists found that this root stimulates the body's own
testosterone production and accounted for some of the
anti-aging properties.
I
believe men want to be on hormonal replacement, and they
need to hear from their doctors that it is safe and
effective. There are insufficient large clinical trials to
say that hormonal replacement is for all men. Before then,
men will continue to use their anti-aging supplements in an
attempt to delay their age. Doctors have a responsibility to
their patients as their practice is rooted on
"evidence-based medicine". At this point, hormonal
replacement for men should be considered on a case-by-case
basis, depending on symptoms. Over the next decade or two,
as more information is available, I do foresee that hormonal
replacement will be more routine and perhaps replace some of
the self-help regimens that men are experimenting with
now.
I would
like to thank Dr. Robert S. Tan for taking his time to
answer my questions. If there is a man in your life who may
be experiencing the symptoms of Andropause, do yourself and
him a favor by reading Dr. Tan's eye-opening book,
The
Andropause Mystery: Unraveling Truths About The Male
Menopause
which is available for purchase online at Barnes & Noble
by clicking the link, or at your local bookstore.
Did you know that About
has a site devoted entirely to Men's
Health?
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