CPhT CONNECT™ Magazine - Jan/Feb 2021

Men’s health ANDROPAUSE

When people think of menopause, they may ini- tially think that menopause affects women as they age. It usually comes as a significant sur - prise to learn that “male menopause” is a real condition. Andropause is the medical term used to describe age-related changes in male hor- mone levels. Unlike menopause (the female counterpart to andropause), not all men will expe- rience andropause, which could explain why so many people are unfamiliar with the condition. What is andropause? What are the symptoms? How long does it last? And maybe the ques- tion that comes to mind first- can it be treated? • BY AN I SHA RAO

to hormonal changes, others for whom testoster- one production declines rapidly are more likely to experience discomfort and unpleasant symptoms. Treating Andropause: It is important to note that a certain amount of age-related decline in testosterone production is considered normal. However, “normal” does not mean you have to indefinitely deal with unpleasant symptoms. Just as many women choose to utilize hormone replace- ment therapy to mitigate discomfort related to menopause, men can also benefit from hormone treatments to reduce the effects and health risks associated with andropause. Using hormone ther- apy may help restore your libido, increase energy, improve mood, and build muscle tone. Testosterone replacements are available in a variety of prepa- rations, including patches, gels, injections, and capsules. Your primary care provider can work with you to determine which treatment is best.

Reduced muscle mass and feelings of physical weakness • Development of breasts • Decreased bone density • Erectile dysfunction and reduced libido • Infertility Some men may also experience other less common symptoms such as swollen or tender breast tissue, decreased testicle size, hot flashes, or body hair loss. In some cases, reduced testosterone levels associated with andropause have been linked to osteoporosis. These symptoms are far less common than those listed above and typically affect men at the same age as women entering menopause. A Little About Testosterone: Men are not born with excessive amounts of testosterone. As men grow and age, levels of testosterone in the body increase. Before males reach puberty, testosterone levels are low, but they continue to increase as men reach sexual maturity. Testosterone is the male hormone that is responsible for changes that take place in the male body during puberty, including: • Increased muscle mass • Growth of body hair and facial hair • Vocal changes including deepening of the voice • Changes in sexual functioning As men age, testosterone levels again begin to drop. According to data provided by the Mayo Clinic, testosterone levels typically decline at a rate of 1% each year after men turn 30. Some medical conditions can cause earlier or more sig- nificant declines in testosterone levels. By the time most men reach age 70 (or sometimes 80), it is common for testosterone levels to have reached half of the peak levels they achieved in their 20s. Diagnosing Male Menopause: It is not uncom- mon for men to feel timid about reaching out to their primary care provider for concerns related to sexual dysfunction. To determine if your symptoms are indeed andropause, your primary care provider will ask a series of questions about your symptoms to see if your physical and psychological symptoms match those of individuals with low testosterone. Next, a blood test is performed to check the level of testosterone in your blood. Because there are other medical conditions associated with low tes- tosterone, your primary care provider will likely conduct additional tests to rule out other medical conditions before making an official diagnosis. When Does Andropause Start? And When Will It End? In rare situations, men in their 30s can experience symptoms pertaining to andro- pause; however, it is significantly more common in men between the ages of 40 and 60. The dura- tion of male menopause is difficult to predict. According to some data, symptoms of male meno- pause can last between 15 and 20 years as the body slowly adjusts to lower testosterone production. While some men may not notice symptoms related

What is Andropause? Andropause occurs when testosterone production decreases in men over age 50. It often coincides with hypo- gonadism (diminished function in the testes), which may result in reduced hormone produc- tion. For men, testosterone is produced in the testes. Therefore, when the gland’s functional- ity changes, it can impact sex drive as well as mental energy, physical energy, and muscle mass. Although andropause and menopause often arrive at approximately the same age, the two conditions differ in a few ways. First, not all men will expe - rience symptoms related to andropause, while all women will experience menopause to some degree. Also, andropause does not result in a com- plete shutdown of the male sexual organs; it just changes the level to which they produce specific sex hormones. This, however, can result in sexual complications due to altered hormone levels. What Are the Common Symptoms of Andropause? Approximately 30% of men over the age of 50 will experience symptoms related to andropause. Andropause can cause several physical, emotional, and sexual dif- ficulties. Generally, these symptoms worsen with age, and andropause goes untreated. Some of the most common symptoms include: • Reduced energy levels • Depression or unexplained sadness • Lack of motivation • Reduced self-confidence • Difficulties with concentration • Changes in sleep patterns • Increased body fat

In addition to hormone replacement treatments, your provider may also recommend lifestyle changes that can naturally increase hormone levels, such as eating a balanced and clean diet, reduc- ing stress, and participating in regular exercise. If you are concerned about andropause symptoms, it is essential that you speak to your primary care provider before adding dietary supplements or altering your current medication regimen in any way. It is also important that your medical pro- vider understand the complex challenges related to hormonal changes in men. Although reduced testosterone is common for older men, it does not mean you have to deal with unpleasant symptoms for years to come. Reach out to your primary care provider today to learn more about andropause and what treatment options may be right for you. Sources: Mayo Clinic. (2020, June 20). Male menopause: Myth or reality? Mayo Clinic Healthy Lifestyle. https://www.mayoclinic.org/healthy-lifestyle/mens-health/in-depth/male- menopause/art-20048056?pg=1 Andropause. (n.d.). MedBroadcast. https://medbroadcast.com/condition/getcondition/andropause Krans, B. (2018, September 16). What Is Male Menopause? Healthline. https://www.healthline.com/health/menopause/male#diagnosis-and-treatment

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