Men may pause, too
Menopause is not a condition peculiar to women, men go through it too. The symptoms are similar, and can affect men as young as 35
Low libido, muscle aches, mood swings, weight gain… all these could be symptoms of age-related hormonal changes in men, usually known as menopause. Male menopause, also known as viropause or andropause (andro meaning male and pause meaning stop), is a recognised medical condition now, unlike 5-7 years ago when no one took it seriously, say doctors. It begins with hormonal, physiological and chemical changes in the body, usually between the ages of 40 and 45, but can occur as early as 35. Experts say at least 5 million men worldwide are affected but given that most men simply ignore the symptoms, attributing it to age, the number could definitely be higher.
A 43-year-old corporate executive, says one doctor, was rudely shaken out of his stressful ‘more work and little play’ lifestyle when he started facing severe loss of libido. Counselling revealed it had begun around 18 months prior to his first visit to the doctor but had worsened over the last 2-3 months. He had to be cajoled into taking a hormone test. The result showed he had slightly low testosterone levels and was suffering from andropause. He refused to believe the doctor’s verdict. But finally, with his wife’s support and encouragement, he started the treatment and within a few months, showed considerable improvement.
So what exactly is andropause?
In medical terms, this is called male hypogonadism and happens when not enough testosterone — the hormone that plays a key role in male growth and development — is produced. The condition leads to significant mental and physical changes. During menopause in women, ovulation comes to an end and hormone production declines and stops in a relatively quick period of time. In men, the hormone shift is more gradual, with testosterone levels dropping around one per cent each year. The process could begin in mid to late thirties. In some men, Andropause can occur naturally. But it can also be triggered by illness, depression, dementia, obesity, diabetes, heavy smoking, too much alcohol, genetic malfunctions or infections like mumps.
It’s important to spot the signs
Not all men experience all symptoms. Also, these may not be as intense as what women go through, but exhaustion, even from simple tasks, mental fatigue, mood swings, lowered fertility, erectile dysfunction and decreased sexual desire are the most common. Urinary problems relating to frequency, hesitation or incontinence are also common. Changes in hair growth and skin quality, lower muscle mass and bone density (making them susceptible to fractures), night sweats and palpitations are other symptoms.
It’s common to dub this phase as a ‘midlife crisis’. That’s because physical changes may be accompanied by changes in attitude and disposition. But unlike women, whose mood swings are also related to physical changes, men rarely go for a routine test to check hormone levels.
Accept the problem, get help
Doctors say men need to accept that such a medical condition exists and can be treated easily. Often simple blood tests and symptom analysis are enough to diagnose it. It’s important to openly discuss the symptoms with the doctor for timely treatment. This may also call for a change in lifestyle, cutting down on smoking, alcohol and stress, exercising, better bonding and acceptance.
Doctors say anxiety, guilt and insecurity cause more damage than the slight fall in hormone levels, as was seen in the young executive’s case. But medical intervention along with yoga and sitar lessons helped him immensely. Meditation, eating right and an active outdoor life also go a long way in tackling the problem.
It can be treated with proper therapy
However, if lifestyle changes alone don’t work, then doctors may consider Testosterone Replacement Therapy, where the testosterone levels are increased through oral tablets, injections, creams, self absorbable implants etc (though tablets are discouraged as they get metabolised in the liver very fast). Testosterone replacement therapy should be conducted only under the supervision of a medical professional after thorough examination and tests. Case selection is important because injecting excess testosterone can lead to unwanted side-effects like baldness and liver problems, and may even increase the risk of prostate cancer.
The heartening news is that it usually takes only three to six months of proper therapy to get your life back on track.
(Expert inputs from Dr Kapil Juneja, consultant, Urology and Andrology, Moolchand Medcity, New Delhi; Dr Rakesh Sahay, endocrinologist, Osmania Medical College, Hyderabad; Dr R Manoj, clinical psychologist, Foundation Dedicated for Research, Education and Awareness of Mental Health (DREAMH), Chennai; Dr Patanjali Dev Nayar, WHO officer and sexual health counsellor based in Manila)
Kavita Devgan is a Delhi-based nutritionist and writer