Johannesburg - Male menopause, or andropause, as it is called, is real.
This is according to Affinity Health CEO Murray Hewlett, who said some of the key symptoms of this highly under-reported condition include fatigue, low libido, depression, irritability, memory loss, and difficulties with memory and concentration, as well as hot flushes and insomnia.
Andropause, despite being an enigma, often sets in in gradual stages, Hewlett said.
“Menopause is widely recognised and understood, most often associated with women reaching a certain age where their reproductive capacities cease. However, another term that’s been stirring the pot in medical discussions, and among over-50s men, is male menopause.”
Hewlett said male menopause, or andropause, does not entirely parallel female menopause, and while women experience a sudden drop in hormone levels (particularly oestrogen), leading to the cessation of menstrual periods and loss of fertility, men’s hormone changes are more gradual. He said the critical player in men’s cases is testosterone, the primary male sex hormone.
Men’s testosterone levels naturally decline as they age, typically starting around middle age. This reduction is about 1% a year after the age of 30. However, this decline is more significant in some men, leading to various symptoms, such as hot flushes, which are also common in women.
Similar to those experienced by women when testosterone levels decrease, hot flushes can affect the hypothalamus, the part of the brain responsible for regulating body temperature.
“As a result, the hypothalamus may misinterpret signals and trigger sudden dilation of blood vessels and sweating to cool the body down.
“Also, decreased muscle strength and stamina. Men experiencing andropause may notice a decline in muscle strength and endurance. They may find it more challenging to engage in physical activities or experience a loss of muscle tone,” he said.
Another key factor, according to Hewlett, is increased body fat and weight gain. “Andropause can contribute to changes in body composition, including an increase in body fat, particularly around the abdomen. This shift in fat distribution can lead to weight gain and a change in body shape.”
There is also joint and muscle pain, as well as changes in hair growth, that men undergoing andropause have to contend with.
“Some men may experience joint pain, stiffness or aching during andropause. These symptoms can be related to decreased testosterone levels, as testosterone plays a role in maintaining joint health and lubrication.
“Andropause can be accompanied by changes in hair growth patterns. Men may notice thinning or loss of hair on the scalp and an increase in hair growth on other parts of the body, such as the ears or nose.”
Hewlett said it was important to note that these symptoms may not solely result from lowered testosterone levels, as they can also be attributed to other agerelated factors, lifestyle choices or underlying health conditions.
“For instance, obesity, diabetes, thyroid conditions or depression can contribute to or exacerbate the symptoms experienced by men during andropause. If you suspect you are experiencing symptoms of andropause, it is essential to consult with a healthcare professional.”
When it comes to diagnosing andropause, Hewlett said it can be challenging.
“Physicians typically rely on a combination of symptom presentation and testosterone levels to make a diagnosis. It’s important to note that testosterone levels naturally vary throughout the day, and a single test might not be sufficient to establish a diagnosis. Consequently, a repeat test or series of tests may be required,” he said.
Testosterone replacement therapy (TRT) is one of the ways to treat andropause. This therapy aims to restore hormone levels to those of a younger man and alleviate symptoms. TRT can be administered through injections, skin gels, patches or implants.
The Star