It is common that people feel less active as they grow older especially upon reaching middle age. However, some doctors are now addressing the deteriorating body condition of men as andropause or “male menopause” while women have a clear indication of menopause.

For many men, it is only a part of ageing as the menopause for males does not have a well-defined period. In general, it is referred to the period when testosterone levels gradually drop. On the contrary, some doctors would prefer to see it as andropause or irritable male syndrome, which is caused by high cortisol levels and can lead to depression.

Can “male menopause” be treated?

While the medical community is still sceptical about the existence of a clear-cut menopause, doctors prove that men receiving hormone therapy with testosterone have shown some improved conditions from the symptoms associated with so-called “male menopause”.

Paul Kozlicki, a former toy company executive who lives in Minnesota, is an example. In his mid-60s, Kozlicki said, “I wasn’t as active, getting lazy, a little less productivity. Not getting things done.”

To find out whether he could be treated, Kozlicki decided to visit Wayzata clinic where Dr Mark Erhard and his wife, Dr Lisa Erhard specialises in bio-identical hormone replacement to treat men who has low testosterone levels. He did a male hormone health questionnaire and went for a blood test after being considered as potential low testosterone.

Kozlicki was implanted with six tiny bio-identical testosterone pellets underneath his skin, and felt the results within a week. He remarked that his quality of life became better while the test results confirmed the pellets had more than tripled his testosterone levels.

Mixed results in large-scale study

Despite the successful case, testosterone therapy is still considered new and the data on whether it treats more than just low libido is mixed. Bruce Redmon, an endocrinologist at the University of Minnesota who specialises in male reproductive and sexual function, said, “I think the better science would question how many of those benefits are real.”

Though Erhard said he witnesses the results in his patients, research done by University of Minnesota screened 50,000 men for low testosterone, but found only 800 with low enough levels to qualify. Of those, 700 participants completed the year-long study and half of them used testosterone gels, which results in improved sexual desire and better walking.

“Men who received testosterone reported better sexual function, including activity, desire, and erectile function, than those who received placebo,” researchers said, but it did not improve focus, change sleep, or lead to walking longer distances.

“Men in the testosterone group were also more likely than those in the placebo group to report that their energy was better,” researchers reported, but overall, they stated that their results showed that testosterone was linked to small but significant benefits with mood and depressive symptoms.

However, the team stressed that larger and longer trials are needed to provide stronger results.

Can low testosterone really cause “male menopause”?

Meanwhile, there have also been questions over whether low levels of testosterone can effect the mood of men over the age of 45 and result in “male menopause”.

Dr Abraham Morgentaler, founder and director of Men’s Health Boston medical clinic stated, “Men with low testosterone find that their emotional reserves are lower. They have a shorter fuse. In popular culture, people link male anger with high testosterone, but as a rule we see it more in men with low testosterone – most commonly when levels are dropping. That’s when men get cranky.”

On the other hand, some experts disagree with the statement that low testosterone causes irritable male syndrome. They suggest that low testosterone could be a symptom of another condition that results in mood swings. Dr Alvin Matsumoto explained it is hard to conclude low testosterone directly leads to menopause as it is easy to feel irritable when experiencing a low sex drive.

As the testosterone therapy is now under investigation for its validity, doctors are reportedly still looking into the uncertainty regarding its risks and benefits. MIMS

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