Male menopause

The so-called male menopause is characterised by the occurrence of the following symptoms, either individual or in combination, and which can be triggered or reinforced by low levels of male sexual hormones.

Synonyms for the male menopause:

• Climacterium virile
• Andropause
• PADAM syndrome partial androgen deficiency in the ageing male)
• Testosterone deficiency syndrome
• Ageing male

What are the possible symptoms?

• Weariness, reduced vigour
• Increased irritability, restlessness and mood swings
• Inner restlessness, fear, loss of concentration
• Reduced interest in sex (loss of libido), impotence
• Thinning of the skin, loss of pubic and body hair
• Reduced muscle power, limb and joint aches, fragile bones (osteoporosis)
• Sweating, increased sensitivity to heat
• Disturbed sleep or increased need to sleep
• Weight gain / increase in belly fat

A case of male menopause is determined when in addition to the above symptoms, an excessively low serum testosterone level has been established several times and other causes of such impairments have been excluded.

What are androgens?

Androgens are male sexual hormones that are mainly produced in the testes. They include testosterone, DHEA (dehydroepiandrosterone), DHEA sulphate and androstendione.

How frequently do androgen deficiencies occur and when?

Scientific studies have shown that the testosterone level in men’s blood falls by around 1-2% per year from the age of 40. This refers above all to the free (i.e. biologically active) form.

What factors promote androgen deficiency?

There are large individual differences. Some men still have normal testosterone levels at the age of 70 and are able to father children at a considerably high age. Other men already display clear signs of testosterone deficiency at the age of 50. These differences are partly due to genetics. But there are many other factors that can have an effect on hormone production. The following factors can promote a reduction in hormone production:

• Excess weight
• Long-term fasting
• Psychological and physical stress
• Drugs, some medications, alcohol
• Severe, acute illnesses e.g. heart attack, infectious diseases and operations
• Chronic diseases, e.g. AIDS, liver disorders, kidney disorders, etc.
• Various medicines that are taken over a long period of time.

When and how is treatment performed?

It is not necessarily the case that every androgen deficiency established in a chemical laboratory test has to be treated! Only men whose blood shows a significant testosterone deficiency and who at the same time suffer from the typical symptoms of the male menopause should be treated. It is possible to substitute the deficient hormone, usually by means of a gel that is applied to the skin, by regular intramuscular hormone injections or with tablets.

Regular urological checks, in particular close-meshed prostate cancer check-ups are necessary during this therapy, because hormonal substitution treatment can have side effects (particular mention should be made in this context of the increased risk of the onset of growth processes in the prostate or of arterial plaque in the vessels).

The success of the treatment also depends on having the right lifestyle: this includes ensuring sufficient physical activity (sport) and a vitamin-rich and balanced diet, also the avoidance of stress, alcohol and nicotine.