WEDNESDAY, June 16 (HealthDay News) -- In describing a set of
concrete symptoms for "male menopause" for the first time, British
researchers have also determined that only about 2 percent of men
aged 40 to 80 suffer from the condition, far less than previously
thought.
Male menopause, also called "andropause" or late-onset
hypogonadism, supposedly results from declines in testosterone
production that occur later in life, but there has been some debate
on how real the phenomenon is, the study authors noted.
"Some aging men indeed suffer from [male menopause]. It is a genuine syndrome, but much less common than previously assumed," concluded Dr. Ilpo Huhtaniemi, senior author of a study published online June 16 in the New England Journal of Medicine.
"This is important because it demonstrates that genuine symptomatic androgen deficiencies [androgens are male hormones] is less common than believed, and that only the right patients [should] get androgen treatment," added Huhtaniemi, a professor of reproductive endocrinology in the department of surgery and cancer at Imperial College London.
Many men have been taking testosterone supplements to combat the
perceived effects of aging, even though it's not clear if taking
these supplements help or if they're even safe. The result has been
mass confusion, not only as to whether male menopause exists but
also how to treat it.
"A lot of people abuse testosterone who shouldn't and a lot of men who should get it aren't," said Dr. Michael Hermans, an associate professor of surgery in the Texas A&M Health Science Center College of Medicine and chief of the section of andrology, male sexual dysfunction and male infertility at Scott & White in Temple, Texas.
For this study, the research team, from Imperial College London
and the University of Manchester, measured testosterone levels in
3,369 men aged 40 to 79 and then correlated these levels with
different symptoms.
Of 32 possible symptoms, only nine were linked with decreased
testosterone levels. Three were physical -- not being able to
engage in strenuous physical activity, not being able to walk more
than 1 kilometer and not being able to bend over or kneel -- and
three were psychological -- low energy, sadness and fatigue.
But these six symptoms were only peripherally linked to low
testosterone levels.
Three sexual symptoms -- less frequent morning erections, lower
sex drive and erectile dysfunction -- were more robustly related to
testosterone levels.
Men need to have all three sexual symptoms plus measurably lower
levels of testosterone to qualify for the diagnosis of late-onset
hypogonadism, the authors stated.
But even with this new diagnostic criteria, the challenge of
treating men with sexual and other symptoms of male menopause is
still far from straightforward.
"These symptoms that are associated with hypogonadism are not necessarily going to be treated by testosterone therapy," pointed out Dr. Natan Bar-Chama, director of male reproductive medicine and an associate professor of urology at Mount Sinai Medical Center in New York City. "We know very well that erectile dysfunction is complicated. It's associated with other co-morbidities and the ability to regain normal erectile function is often not successfully treated with just testosterone."
"Just because an older guy comes in and says he has a bad sex life, you don't automatically give him testosterone," Hermans added.
And even though there are any number of testosterone products
available -- from patches to pellets -- there isn't much research
on how much they really help men, Hermans said, or whether they are
safe.
More information
The U.S. National Library of Medicine has more about
hypogonadism.