Male “Menopause”…Is there such a thing?

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Dr. Crawford describes the condition of male hyopogonadism and outlines the diagnosis and treatment of the problem.

Yes, by all means, but it is technically called hypogonadism (low testosterone levels). Symptoms may vary, but most men will experience decreased libido (sexual desire) as well as erectile dysfunction, hot sweats, decrease in body hair, fatigue, or even depression. They also tend to lose muscle mass and gain weight due to increased subcutaneous fat.Erectile dysfunction is a common complaint of male patients past the age of 50, and although it is most commonly caused by such problems as vascular insufficiency (decreased blood flow) to the penis which usually responds well to such medications as Viagra, Cialis, or Levitra, your physician should check for hypogonadism as a possible cause and also screen for cardiovascular disease as well as diabetes. Certain prescription medications can also lead to problems with both libido and sexual dysfunction; most notably certain anti-depressants and hypertensive medications.

Serum testosterone levels are at their highest between the ages of 20 to 30 and tend to progressively fall after age 40. If your testosterone levels come back low, your physician may wish to order a couple of other tests to determine the actual cause. There are other causes of low testosterone other than merely aging. If your testosterone level IS low and you are going to receive treatment, make sure that you are screened for prostate cancer. Your doctor should perform a digital rectal exam, order a PSA (prostate specific antigen) blood test, and your testicles should be examined for size, nodules and other abnormalities.

Topical testosterone gel is usually the preferred method of administering the hormone. Topical 1% testosterone is available as Androgel or Testim. The starting dosage is 5 gm a day and applied to dry skin of the abdomen, upper arm or shoulders. The gel should not be placed on the genitals! The area of skin should be allowed to dry and a shirt be worn during contact with children or women as it IS possible to transfer the medicine to the skin of another individual. The serum testosterone level should be determined again about two weeks after initiating treatment.

The administration of testosterone replacements have NOT been demonstrated to increase the incidence of prostate cancer, myocardial infarction, cardiovascular disease, or stroke. It can, however, elevate the PSA (prostate specific antigen) level.

Treament has come a long way over the past few years with the advent of the topical applications. Testosterone used to be given by intramuscular injection which was both painful and had to be given rather frequently because the levels of the medication would not last long in the blood stream. The topical applications tend to maintain an even level of medication at all times without the peaks and valleys caused by the old injections.

Testosterone replacement should improve libido, muscle mass, and well being. It can aggravate sleep apnea, cause mild acne, and gynecomastia (slight enlargement of the breasts), but NOT in everyone.

It can enable a male to feel much more vibrant, improve his sexual desire, ability, and performance, and make life a lot more enjoyable overall.

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Author: Piyawut Sutthiruk

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