Andropause
(a.k.a.
Male Menopause, Midlife Crisis)
Between the ages of 40 and 55, men can experience a
phenomenon which is similar to the female menopause that is referred
to as male andropause.
When a woman reaches her late forties or early
fifties, she undergoes bodily changes associated with reduction of
female sex hormones and the ending of her periods. These changes are
often associated with symptoms such as hot flashes, mood swings and/or
depression, vaginal dryness, atrophic changes in the vagina and skin,
reduced sexual desire, and an accelerated bone loss leading to
osteoporosis. These changes in a woman are called the female
menopause. The symptoms and signs associated with this condition can
generally be corrected with the judicious use of natural hormonal
replacement therapy. Unfortunately, most gynecologists today do not
use natural female hormones for replacement, but rather synthetic
hormones or hormones that do not entirely match the female hormones
that are being replaced.
The concept of a male andropause has been more
controversial than that of the female menopause, with many arguing
that it doesn’t exist. Part of the reason for the controversy is
that, in contrast to women, men do not have a clear-cut external
signpost, namely the cessation of menstruation. Nevertheless, even
though women do have this clear-cut demarcation, the changes that take
place in their bodies associated with the stopping of menstruation,
occur gradually over months or even years. This period, during which a
woman may experience irregular menstrual periods, hot flashes, mood
swings and other bodily changes, is often called the peri-menopausal
period.
A man often begins to experience changes in his body
somewhere between ages 40 and 55. These bodily changes may be
accompanied by changes in attitudes and moods. During this time a man
frequently begins to question his values, accomplishments and the
direction of his life. The entire gestalt of these changes has led to
the notion of the mid-life crisis. In this series, I’ll not focus on
all aspects of these changes, but rather on the physical bodily
changes that has been termed the male menopause or andropause. We’ll
look at what occurs and what can be done to slow down these inevitable
changes of aging.
The physical changes that occur with andropause may
be divided into: (1) urinary and sexual changes and (2) more
generalized changes. The urinary-sexual changes, which may occur in
any combination and in varying degrees, include: (1) reduced sexual
desire or libido, (2) reduced sexual potency or difficulty developing
or maintaining erections, (3) ejaculatory problems, (4) reduced
fertility, and (5) urinary problems, such as increased urinary
frequency-especially at night, a weak urinary stream, hesitancy during
urination, difficulty starting urination, and urinary incontinence.
All of these changes, as I shall show, may be due, at least in part,
to a gradual failure of the testes’ production of testosterone, the
male sex hormone. This would be analogous to the changes seen in a
woman, who at the time of menopause, has a reduction in the female sex
hormones, estrogen and progesterone.
