Male Menopause: Painful Message

Today's Health Magazine

Recent studies, however, have supported the notion that men undergo hormonal, chemical, physical
and psychological changes as they age.   A 1993 study found that about half of men in the United States have experienced middle life impotence to varying degrees. The aging Baby Boom generation guarantees that the percentage will increase.

It's a scenario ingrained in the popular imagination. The balding, 40 something guy dumps his wife, buys a convertible, and becomes a pathetic fixture at the local nightclubs. Another victim of the male mid-life crisis, you say. But is there a physiological basis for such behavior?

Our middle-aged party animal is undergoing a psychological crisis, to be sure. But there may be a very real physiological change-taking place beneath the turmoil on the surface. In medical circles its called "andropause" or "viropause", but it's popularly known as "male menopause".

The stereotypical male mid-life crisis is not synonymous with male menopause. The former is a psychological reaction to the loss of youth; the latter is a very real physiological condition, experienced by a minority of men that is linked to a reduction in the production of testosterone. But the hormonal change often triggers psychological difficulties, including depression and feelings of low self-esteem.

The bad news: About 40 percent of men over 40 will experience some symptoms of male menopause, including a loss of sexual drive and the resulting psychological difficulties. The good news: The decline in male virility can be delayed.

Testosterone levels begin to decrease slightly in all men after they reach 40 of so. But some men experience abnormal declines in testosterone production, a hormonal change that can cause serious sexual dysfunction. They also may suffer from a lack of virility in general, and the combination of sexual impotency and sagging virility can trigger a psychological mid-life crisis.

Medical expert's point out that the term "menopause" is a misnomer when applied to men. A man's reproductive glands don't cease functioning the way women's ovaries do. But a man's sexuality definitely changes advancing age. The male "life change" typically occurs between the ages of 45 and 60. Unlike women, men can continue to father children, but the production of the male sex hormone, testosterone diminishes gradually after the age of 40. And while a women's menopause lasts about four years, male menopause can stretch out over a 15-year period.

Testosterone is the hormone that stimulates sexual development in young males. In adult men, it stimulates the growth of bone and muscle. Studies have shown that, by age 55, the amount of testosterone secreted into the bloodstream is significantly lower that that of a man of 45. By age 80, testosterone production in most men has dropped to pre-puberty levels.

Myth or Medical Fact?

The very notion of male menopause has long been a subject of debate in the medical community. Two US doctors in a 1944 article first identified the condition. But the findings went largely unnoticed. Doctors were hesitant to acknowledge the presence of the physical condition, in part because the hormonal changes were intertwined with psychological difficulties. "You're just having a mid-life crisis," patients were told. So men who were experiencing very real symptoms were undiagnosed and untreated.

Another obstacle to diagnosis and treatment of menopausal symptoms has been men's reluctance to talk about them. The physiological symptoms appear at a time of great emotional stress. By the time men reach there 40s and 50s many of life's great struggles are behind them. The priorities that were paramount in their youth are beginning to be supplanted by new ones. The game has changed.

Still, some experts question the validity of "male menopause" as a medical term. They argue that only a small minority of men experiences an unusually low production of testosterone, a condition called "hypogonadism."

Symptoms:

The symptoms of male menopause are similar to, but less pronounced than, those experienced by menopausal women. It is estimated that about 40 % of men between 40 and 60 will experience some degree of lethargy, depression, increased irritability, mood swings, insomnia, decreased libido, weakness, loss of bone mass and impotence.

Who is Affected:

Recently studies, however, have supported the notion that men undergo hormonal, chemical, physical and psychological changes as they age. The aging of the Baby Boomer generation guarantees that the percentage will increase. The number of men between 40 and 70 is projected

To grow to 54 million over the next 20 years. That's a 60 % increase in the male menopausal population. A 1993 British study of 802 older men estimated that nearly a third of all British men over the age of 50 do not have sexual intercourse.

What you can do:

Men suffering from impotence or other symptoms of menopause shouldn't rush out for Viagra or testosterone replacement. A few lifestyle changes might work miracles. The usual suspects-drinking and smoking-are the culprits once again. Alcohol makes it more difficult for the body to send signals to penile tissues, and prolonged and excessive use of alcohol is thought to cause irreversible damage to the nerves in the penis. Smoking, which reportedly damages the penile blood vessels that are essential for an erection, may be the single greatest cause of male sexual dysfunction.

A healthy diet, low in cholesterol, is also thought to ease impotence. And men who exercise regularly report greater sexual satisfaction than sedentary men do. So, before joining the stampede to medication therapy, try the natural remedies of a more healthful lifestyle.

  Eat a nutritious, low fat, high fiber diet.
  Get plenty of sleep.
  Exercise regularly.
  Find a supportive friend to discuss the situation.
  Limit consumption of alcohol and caffeine.
  Drink lots of water.
  Stop smoking.

If your doctor determines that treatment is required, there are a variety of approaches, including pumps and surgical procedures that have proven effective for treating impotence. And a new generation of drugs promise to revolutionize the treatment of impotence.
Hormone Replacement Therapy (HRT) holds tremendous promise for treating-and perhaps reversing- a variety of the maladies of aging, in both men and women. Testosterone replacement, in particular, remains a controversial treatment, thanks to abuse among athletes and a reported greater risk of prostate cancer. But the National Institute of Health is pressing ahead, asking for research proposals to investigate whether testosterone supplements benefit older men by preventing bone loss, depression and other symptoms related to aging. Testosterone supplementation is currently available through shots, implants and a patch.
The potential of HRT may seem enormous, but doctors warn that testosterone replacement is effective only for those men whose impotence is caused by low hormone levels.

It's a fact of life: As we age, our bodies change. But modern medicine isn't giving up. Neither should you!