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Is male menopause real or just a midlife crisis?


Symptoms: depression, irritability weakness, loss of libido, loss of memories, mood swing, increased fat

What is male menopause?

Male menopause. It describes age-related changes in male hormone levels. The same group of symptoms is also known as testosterone (man’s hormone) deficiency which involves a drop in male hormone who are age 50 and over.

Depression, irritability, weakness, loss of libido (sexual dysfunction), mood swing, inability to concentrate, loss of memory, decrease energy, decreased muscle mass, increased fat are some of the menopause symptoms in men.

What is testosterone?

Testosterone is a hormone found in humans, as well as in other animals. In men, the testicles primarily make testosterone. Women’s ovaries also make testosterone, though in much smaller amounts. The production of testosterone starts to increase significantly during puberty and begins to dip after age 30 or so. Testosterone is most often associated with sex drive and plays a vital role in sperm production. It also affects bone and muscle mass, the way men store fat in the body, and even red blood cell production. A man’s testosterone levels can also affect his mood.

Low testosterone and age

When you think of declining levels of testosterone, you might think of middle-aged or older men. But men under 30 can also experience low testosterone, or “low T.” According to the test, testosterone levels tend to peak in men during adolescence and early adulthood. Those levels typically decline by about 1 percent each year, starting around age 30. But in some cases, you may experience declining testosterone at a younger age. Low T is a medical condition where your body doesn’t produce enough of the hormone testosterone. Both men and women produce testosterone, but it’s called the “male hormone” because men produce a lot more of it. It’s critical for many male characteristics, including the maturation of male sex organs, sperm development, muscle mass development, voice deepening, and hair growth. Low T can cause a variety of symptoms, including erectile dysfunction, infertility, muscle mass loss, fat gain, and balding.

If you think you might be experiencing low T, make an appointment with your doctor. In some cases, it is caused by unhealthy lifestyle habits that you can change. In other cases, it is caused by an underlying medical condition that requires treatment. Your doctor can help you identify the cause of your symptoms and learn how to manage them.

What causes low testosterone in young men?

Low T is less common among men under 30, but it can still occur. Contributing factors include: high cholesterol levels, high blood pressure, being overweight or obese, drinking excessive amounts of alcohol, using illegal drugs, using anabolic steroids, taking certain prescription medications such as steroids and opiates, especially in excess, some cases of low T may be linked to other medical conditions, such as: hypothalamic or pituitary disease or tumors, injuries, tumors, or other conditions affecting your testicles including inflammation related to childhood mumps, inherited diseases, diabetes, liver disease, or Aids, cancer treatments such as radiation and chemotherapy

What causes the male menopause?

After the age of 30 years a man’s testosterone hormone levels start to drop, about 1% each year. Most men in their seventies have at least 40% less testosterone in their system than they did when they were 30. However, the normal decline of testosterone levels that comes with age is not believed to be the only cause of male menopause. If it were, every man would experience it, and this is not always the case. Although male menopause occurs in older men whose testosterone levels have declined, it tends to affect older males with heart disease, obesity, hypertension (high blood pressure) or type 2 diabetes. In other words, unlike the female menopause, several factors together contribute to the development of male menopause. Some underlying health problems, lack of exercise, smoking, alcohol consumption, stress, anxiety, and sleep deprivation could also be key factors.

Psychologists suggest the male “midlife crisis”, when men are supposed to wonder what they have accomplished so far professionally and personally, can be a cause of depression and might possibly trigger a cascade of factors that lead to symptoms associated with male menopause.

Are there ways to be diagnosed and treated here in The Gambia too?

There is menopause in men but most do not realise that men experience a change in their hormonal production and balance that in many ways is very similar to women’s menopause. It is called andropause or menopause in men. In fact, andropause is often referred to as “male menopause”. Men go through a change very much like women in their middle years, they like women, experience complex hormonal rhythms that affect their sexuality, mood, and temperament. But some men don’t experience much of a crisis; they just continue living through the first part of their life and the second. Others go through a period of great turbulence, but then are redeemed and find a new course and approach for the second passage of their lives.

And, of course, every person is different. And not all men going through all these stages of life will experience it exactly the same way. The passage into middle age is complicated. It has many personal, social, economic and family implications. It may therefore be difficult to differentiate these changes from the symptoms of other conditions that can create some of the same symptoms. Men menopause occurs when a man’s production of hormones declines to below normal levels. These hormones include testosterone (man’s hormone), thyroid, and human growth hormone (HGH). In addition, production of estrogen’s (female hormone) actually increases in men undergoing menopause.

A man’s testosterone level typically begins to fall by the time he reaches his 50s, but for many men it may start to occur in his early 30s. The diagnosis of menopause in men should include complete blood count and chemistry profile, which can be tested in various labs in The Gambia.

The balance between testosterone (man’s hormone) and estrogen’s (female hormone) is very important. While some estrogens protect against osteoporosis (bone’s degeneration) by increasing bone density and may decrease the risk for prostate cancer, men’s testosterone level should be greater than their estrogens’ level. In many men over fifty, the estrogen’s level is greater than the testosterone level, which is unacceptable. The choices for supplementation of testosterone in males are quite numerous at this time, but only a few are commercially available. Patients and their physicians have options to choose from that best fit their needs which include: topical gels, creams, oral capsules, and injectable forms.

Patients taking testosterone supplements should have their testosterone and estrogen’ levels measured after four to six weeks to determine if they are receiving the proper dose of medications. The goal of therapy in treating male menopause is hormone replacement to achieve younger, healthier levels in order to reverse the signs of menopause and the effects of ageing. Treating male menopause may also have positive effects on blood pressure, diabetes, heart disease and arthritis.

Male menopause begins with hormonal, physiological chemical changes that occur in all men generally between the ages of forty and fifty-five, though it can occur as early as thirty-five or as late as sixty-five. These changes affect all aspects of man’s life. Male menopause is thus a psychological, interpersonal, social and spiritual dimension. Men have reported having as many premenstrual type symptoms as women do as mentioned (reduced or increased energy, irritability, and other negative moods, black pain, sleeplessness, headaches, confusion, and so forth).

Hormonal changes greatly affect men going through male menopause. Lower levels of hormones at midlife are central to the changes associated with male menopause. Recent research indicates that lowered levels of man’s hormones may decrease sex drive, increase depression and weight gain, and contribute to a general decrease in wellbeing and health: Men, like women, experience complex hormonal rhythms that affect their sexuality, mood, and temperament. Studies show, four different testosterone cycles in men: Rhythmic fluctuations three to four times an hour. Daily changes with testosterone higher in the morning and lower in the afternoon. Monthly fluctuations are rhythmic, but different for each man.

Decreasing levels of testosterone associated with male menopause occurs as men get older. A man often begins to experience changes in his body somewhere between the ages of 40 and 55. These bodily changes may be accompanied by changes in attitudes and moods. The aging process alone cannot be responsible for this problem as well over 40% of males remain sexually active at 70 years of age and beyond.

Treatment options

If it is found that a man has low testosterone, your doctor may recommend testosterone replacement therapy, which could help relieve the male menopause symptoms. This therapy can be done through patches, injections, gels, creams and oral form. Before any treatment begins, discuss the pros and cons of having testosterone replacement therapy with a doctor. If you suspect that you might have low T, make an appointment with your doctor. They can use a simple blood test to determine your testosterone level. If your doctor finds that your testosterone level is lower than normal, they may order additional tests or do an exam to investigate why. Your treatment plan will depend on your diagnosis and medical history. Your doctor may recommend lifestyle changes or testosterone replacement therapy.

What is the difference between male menopause and female menopause

As a woman’s reproductive hormones reduce to the point where ovulation and menstruation stops, the end result of menopause is that the woman becomes infertile and can no longer have any children. Although men suffering from andropause have lower levels of testosterone, their fertility is not affected.

Where in The Gambia

There are various government hospitals, EFSTH, MRC, NGO and private clinics in the country where you can visit for further information, be diagnosed and undergo available treatment.

Dr Azadeh is a senior lecturer at the University of The Gambia, senior consultant in obstetrics and gynaecology, and clinical director at Medicare Health Services. He can be reached at: Email: [email protected]; text on WhatsApp from 3pm to 6pm working days only to 002207774469.

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