Male Menopause: Myth or Reality

American men are being sold a new urban myth: male menopause. They are being told that their supply of the hormone testosterone decreases dramatically as they approach middle age, and that almost every area of their health and happiness will be compromised. Then they are being told they need to take potentially risky drug therapy to fix the problem. The truth is that most of the talk about male menopause is much exaggerated.

"Male menopause is not a valid medical term," says Dr. James Drinkard. "We have no evidence of a true male menopause that is comparable to female menopause."

Menopause describes the time during middle age when women's menstrual periods stop, due to a rapid decline in levels of the female hormone estrogen. While testosterone levels do decline a little as men age, the process is much more gradual compared to women, and with much less powerful effects.

Those who believe in male menopause say the symptoms include low energy or fatigue, depression, weight gain, reduced libido, and loss of overall strength. If you have any of these symptoms, however, they may be due to medical conditions or stress unrelated to testosterone levels.

For most men, the effects of declining hormone production are natural and gradual, and don't require treatments such as hormone replacement therapy (HRT). A growing number of men are now being sold prescription testosterone replacements in shots, pills, and patches. But be aware that some promoters of HRT may be more interested in your money than your health.

Low testosterone should not cause life-threatening health problems, but taking too many hormone supplements can. Here are the facts:

• Data on the benefits of HRT for men is currently inconclusive.
  
• There is no documented benefit for HRT in men unless a deficiency of testosterone is demonstrated by chemical testing.
  
• HRT in large doses (especially in the oral form) can be dangerous for men, increasing the risk of prostate enlargement, prostate cancer and liver diseases.
  
• It does not take much to exceed safe dosages of testosterone therapy. HRT should only be given under a physician's care, which includes regular prostate exams and blood testing.
  
• HRT is usually only appropriate for men diagnosed with an unusual condition called hypogonadism, which is an extremely low level of testosterone.

Also beware of synthetic steroid drugs, which increase testosterone levels and have been known to be dangerous. And finally, you may see over-the-counter products claiming to boost testosterone levels at your drug store or health food store; don't assume that they are effective or safe just because they're available without a prescription.

The sex hormones — male androgens and female estrogens — are produced by the adrenal glands on top of your kidneys. Testosterone is present in men and women, and it's responsible for the sex drive in both. However, testosterone is an ineffective treatment for impotence, because it affects the libido but not sexual functioning.

Testosterone production is highest for males during puberty and declines very slowly with age, but does continue through a lifetime.

If you view your gradual decline in hormone production as a natural part of aging, you can work with it instead of fighting it. Here are some goals to work on for a long and healthy life:

• Eat smart and exercise regularly (without steroids to build muscle).
  
• Watch your stress level and take time to relax.
  
• Quit smoking and use alcohol with caution, if at all.
  
• Consult your doctor on how often you should have a physical exam.

Don't disregard this last point. According to the National Men's Health Foundation, the life expectancy for men is an average of seven years less than for women, despite recent medical advances. One reason might be that women visit their doctors almost four times more often as men.

Seeing a doctor for an annual check-up visit will help you develop a valuable record of your medical history and recognize problems before they become serious. For best results, form an ongoing relationship with one physician, such as a primary care physician available through your health plan. It is important to remember that if you do have an identifiable problem, see your doctor. You may be able to be referred to a urologist or other type of specialist.

If you want to work toward a healthier lifestyle, you don't have to do it alone. South Coast Medical Center can help. Please call the Health Resource Center at (949) 499-7202 to find out about our free and low-cost health classes or for help finding a physician.

Note: This is for information purposes only and not intended for use in place of the advice of a physician.