Male menopause
Menopause in men is a set of changes in the body that occur with age. They are caused by the degradation and hypofunction of the reproductive system, and especially of the male sex glands. Men’s menopause is characterized by a weakening of sexual desire, potency, general depression of sexual function, disorders of the cardiovascular system, the occurrence of painful sensations in the heart, hot flashes, dizziness, increased sweating. There are also symptoms of metabolic disorders: muscle mass decreases, osteoporosis occurs, skin atrophy. The emotional background of a person is unstable.
The content of the article:
Causes of men’s menopause
Symptoms and signs of male menopause
Diagnosis of menopause in men
Treatment of menopause in men
What is the prognosis for men’s menopause?
Male menopause
The terminology of this process is still in question. If in the case of female menopause, doctors really came to an agreement, since the symptoms are obvious — the cessation of menstruation and the loss of the ability to get pregnant, then in the case of the oppression of sexual and reproductive functions in men, everything is not so clear. Discussions about the definition of this period in a man’s life cover such areas of medicine as urology, endocrinology and andrology. Many doctors still doubt whether men have menopause.
On the other hand, it is confirmed that the production of androgens decreases with age, and this entails a chain reaction of the appearance of certain pathologies in various areas of the body. Male menopause can also be called andropause, age-related androgen deficiency, age-related hypogonadism and testosterone deficiency syndrome.
The main criterion for determining whether men have menopause is the result of a laboratory analysis, which confirms a drop in the level of testosterone in the blood corresponding to age.
It is possible to treat male menopause only by relieving symptoms, for which androgen replacement therapy, homeopathy, psychotherapy, etc. are used. Other medications are rarely prescribed.
Causes of men’s menopause
The manifestation of symptoms of male menopause directly depends on his age. After all, this process is directly related to hormones, namely: a decrease in the level of secretion of testosterone — the main male sex hormone. Since its main part is produced in the testicles by special Leydig cells, as well as by the adrenal cortex (the whole process begins at the embryonic age), the hormone level begins to fall when a man reaches 35 years of age. Every year, the level of testosterone generation drops by 1-3%, which causes changes in the entire life of a man, since it affects his most important system of interaction between the hypothalamus, testicles and other organs.
After a man reaches a certain age, the concentration of globulin in his body increases, which binds the genitals. This means a gradual increase in the amount of testosterone that binds to them. Such a hormone will no longer be able to enter the tissues, and there is also an imbalance between the level of estradiol and testosterone, i.e. the amount of estrogen in the blood increases.
Despite the fact that by the age of 80, the level of decrease in the main male sex hormone is close to 60%, this still does not give doctors a reason to diagnose hypogonadism. All the above-described changes in the body of a man are characterized by an increase in the concentration of follicle-stimulating hormone, a decrease in melatonin, an increase in the level of estradiol.
Thus, the age of menopause in men is the period of time when the number of Leydig cells decreases, the functioning and balance of the pituitary system is disrupted. The reason may be not only an age-related change, but also a man’s genetic predisposition. Inflammatory infection of the genitourinary system, epidemic mumps, trauma and testicular tumors in the anamnesis, harmful influence of environmental factors — radiation, chemistry, intoxication of the body can accelerate the approach of menopause.
Symptoms and signs of male menopause
The signs of male menopause are very diverse, since the deficiency of the main male sex hormone causes an imbalance and disruption of many human body systems. Thus, the most striking symptoms are manifested when the reproductive, cardiovascular, musculoskeletal systems and the central nervous system do not work properly. Early male menopause is diagnosed in the presence of broad symptoms already at the age of 45, but if the manifestations have become most pronounced only by the age of 60, then a diagnosis of late menopause is made. By the age of 40-50, about a tenth of men notice the manifestations of menopause, this number doubles at the age of 60.
The first changes relate, of course, to the male sexual system, which is characterized by a decrease in libido, more infrequent sexual intercourse, deterioration of erection and almost complete absence of morning spontaneous erections, sexual dissatisfaction. A man may notice a decrease in the sensitivity of the penis during sexual contact, or note difficulties in achieving orgasm. It is also characterized by a decrease in the intensity of sensations during orgasm, premature ejaculation and a decrease in the volume of ejaculated seminal fluid. Separately, the problem of the genitourinary tract develops: weakening of the jet, urinary incontinence, constant urge to go to the toilet, nocturia.
The above symptoms do not pass without a trace for the psychological state of a man during this period. The extinction of sexual function has a particularly strong effect, this process causes a constant decrease in mood, depression, sleep disorders, irritability. Productivity and physical strength decrease, and fatigue and weakness, on the contrary, increase. A man, in addition to all of the above, may note a deterioration in memory, the ability to perceive, remember and analyze information. Also, vegetative manifestations of male menopause are considered excessive sweating, hot flashes, constipation.
There are other signs through which menopause reveals itself in men, symptoms develop both from the heart and the vascular system of the body. This is expressed in fluctuations in blood pressure, bringing discomfort to a man, sudden attacks of palpitations, cardialgia, arrhythmia. Cholesterol levels rise, which can cause problems with the coronary and cerebral arteries — atherosclerosis. The risk of myocardial infarction and stroke increases.
Metabolism is also subject to disturbances if men’s menopause makes its own changes in the normal hormonal background. The obvious signs of problems in this case are an incorrect exchange of lipids, minerals and carbohydrates. As a result, there is a decrease in muscle mass, an increase in fat, gynecomastia, obesity, diabetes, metabolic syndrome. Due to impaired metabolism, men’s bones also suffer, the risk of getting a fracture increases greatly. The skin is also subject to significant changes, its aging is manifested in the appearance of wrinkles, dryness, flabbiness, a decrease in the amount of hair on all parts of the body.
Diagnosis of menopause in men
A lot of tests are used for menopause in men: age, symptoms that the patient may notice are not eloquent enough to make a diagnosis. A wide variety of specialists are often involved to relieve individual symptoms of menopause: an endocrinologist, an andrologist, a cardiologist, a neurologist, a psychotherapist. Despite the possible successful treatment of individual manifestations of male menopause, it is necessary that the patient is constantly monitored by a urologist or andrologist to eliminate the true cause of the problems.
Androgen deficiency of an age-related nature, which determines men’s menopause, the treatment prescribed for its relief and supportive therapy are used all over the world. This means that the patient first undergoes a study on the level of total and active testosterone in the blood, checks the amount of other hormones, then undergoes a specialized questionnaire — an assessment of age-related androgen deficiency, the severity of erection, urinary tract obstruction.
Among other prescribed methods of examination of the patient, if necessary, to treat male menopause, ultrasound examinations of the scrotum, prostate, vessels of the penis, rectal finger examination of the prostate gland take their place. An echocardiogram is performed for the heart, blood vessels of the head and neck. The state and course of metabolic processes are diagnosed.
When men have menopause, it is necessary to carry out a lot of additional procedures that will help differentiate it from other similar diseases. For example, age-related androgen deficiency is separated from traumatic brain injuries, tumors of the hypothalamus or pituitary gland, infections, inflammation, endocrine problems such as hyperprolactinemia, hepothyroidism, thyrotoxicosis.
Treatment of menopause in men
Having found out that men have menopause, it is necessary to move on to understanding on what principles the treatment of this inevitable problem is based. It is known that this phenomenon is age-related, but it is impossible to describe in a standard way how men’s menopause goes.
First of all, medication therapy is prescribed, which treats menopause in men, manifestations can be stopped by non-drug methods. Testosterone replacement therapy is used, which means that the patient receives a dose of testosterone in various forms, whether it is a tablet, injection, gel, patch, as it will be more convenient and effective in one case or another. Only a specialist should prescribe it, and during the entire course a man should be monitored by an andrologist and an endocrinologist. Such medical treatment is aimed at reducing the level of depression, increasing libido, the quality of sexual contacts, physical strength and endurance.
