THE MALE MENOPAUSE – FACT OR FICTION?

The word "menopause'' literally means the cessation of menstrual bleeding. In females it signifies that the biological clock has stopped and infertility sets in accompanied by dramatic hormonal changes. So, the word "menopause" cannot apply to men. Yet, even though they seem to be on easy street compared to women, it is indeed a fact that men also are vulnerable to fundamental emotional, mental and physical changes at about 50 years of age and beyond and when Hormone Replacement Therapy (HRT) may be of help to men as well as women.
The first semblance of Hormone Replacement Therapy (HRT) was used on a man in 1889, when a famous neurophysiologist Charles-Edouard Brown-Sequard, gave himself an extract of animal testicles. In his own words this produced "a return of vigour, youthful appetites and desires" due to the male hormone testosterone contained in the animal testicles.

Hormonal Changes In Men
Testosterone production from the testicles is at its peak during the 20s and 30s, and thereafter a slow decline occurs which becomes more pertinent after the age of 50. Despite this, there is a large variation between individual males so that some men at 50 may produce such low levels of testosterone that they no longer feel any inclination to have a sex life, whereas others at 80, have high testosterone levels and are still sexually vigorous. As you are reading this you are probably wondering how you (if you are male) or your partner can be one of the lucky ones and nurture those testicles all the way along throughout life. The ability to produce testosterone is partly genetic so that in many cases it's "like father, like son". We also know that lifestyle plays a role and men who smoke and/or drink alcohol excessively will have lower levels of testosterone in their blood.
As a man ages, not only does the production of testosterone diminish, but so does the ability of his tissues and cells to respond to testosterone. It is a simple matter for a man to see if his testosterone production is down by asking for a blood test.
A deficiency of testosterone would be obvious if the blood level was below 8nmol/L, the normal range of testosterone in the blood being 11 to 37 nmol/L. This would be further corroborated by high blood levels of the pituitary hormone called Luteinising Hormone (LH) which is indicative that the pituitary gland is trying to stimulate the sluggish testicles. This blood test could be repeated on three separate occasions, at eight-weekly intervals to demonstrate any trends before deciding if male HRT is needed.

The Symptoms of Testosterone Deficiency
Testosterone deficiency shows up in:
1.         Reduced libido, fatigue and behaviourial changes;
2.         Shrinkage (atrophy) of the muscles, testicles and penis and softening of the testicles;
3.         Reduced rate of growth of facial and body hair;
4.         Reduction in virility and ability to achieve orgasm. In severe cases, impotence.
A male who has previously had high levels of testosterone may find that the decreasing testosterone levels that can begin to occur after the age of 50 produce subtle mental and physical changes even though his blood test reveals that his testosterone levels are still within the normal physiological range of 11 to 37 nmol/L. This is because his testosterone levels are much lower than they used to be and he is sensitive to the decreasing levels.
Subtle changes of decreasing testosterone production may range from depression, loss of confidence, loss of drive and aggression and loss of competitiveness in all spheres. The warrior man finds himself becoming a bit of a mouse. If such a male takes himself along to the doctor he may be told that all this is symptomatic of the psychological male midlife crisis, especially after a full physical checkup fails to reveal any medical problems. He may be told that this crisis is due to a plateau in his career, looming retirement, unrealised ambitions, getting older, overdoing it, or stress.
He may be offered a course of anti-depressants, sedatives or tranquillisers and referred for counselling to assuage his growing self-doubts. Men are more reluctant than women to accept a course of such therapy preferring to numb their anxieties at the bar with their mates. Unfortunately, alcohol ingestion, if it becomes regular or excessive, often further reduces the production of testosterone leading to an aggravation of the mental and physical imbalance.
It is vital to check the possibility of a hormonal contribution and, if this is suspected, a short trial of hormone replacement therapy with testosterone can be tried.
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