With international men’s day taking place on November 19, Irish men are being urged not to ignore the symptoms of andropause, dubbed the ‘male menopause’.
Dr. Deirdre Forde, founder of Ceile Medical in Athlone, Co. Westmeath, said that while the idea of the male menopause may often be dismissed as a myth, it is a very real and serious issue for some men.
She said she has already treated two farmers who were affected by andropause. One was a 52-year-old full-time farmer who suffered from tiredness and found himself becoming intolerant of things and situations that would not normally bother him.
A visit to his GP resulted in him getting his bloods checked and then being told to take a break from the rat race of life. However, the farmer said he felt exasperated when he returned to the farm as jobs hadn’t been done.
Exhaustion
Exhaustion affected his work, personal and social life and he was no longer a happy-go-lucky individual, he said. A friend suggested he make an appointment with Dr. Forde who prescribed treatment which he had been taking for three months.
While his energy levels had improved, they were still not yet at full throttle, he reported. However, he was sleeping and eating better and felt more motivated. He said he believed that he had a solution that worked for him.
Andropause, Dr. Forde said, is a condition associated with the decrease in the male hormone testosterone. “It is unlike menopause in that the decrease in testosterone and the development of symptoms is more gradual than what occurs in women.
Approximately 30% of men in their 50s will experience symptoms of andropause caused by low testosterone levels. A man experiencing andropause may have a number of symptoms related to the condition and could be at risk of other serious conditions such as osteoporosis without proper treatment.
Common symptoms, Dr. Forde said, can range from low sex drive to hot flashes and depression to loss of muscle mass.
“A blood test and other tests can be carried out when making the diagnosis but like oestrogen levels in women, it might not tell us much. It’s important to bear in mind that many of the symptoms of andropause are also a normal part of ageing and may not be reversible with treatment.”
Testosterone is available in a variety of preparations including skin patches; capsules; gels; and injections, Dr. Forde said.
“Primary care doctors – GPs – can prescribe gels but patches and injections are a function of an endocrinologist where a man has severe testosterone deficiency diagnosed with blood tests and may be due to androgen deficiency caused by problems in the brain – pituitary and hypothalamus – or in the testes,” she said.
Clinical entity rather than a myth
Dr. Forde began to explore andropause as a clinical entity rather than a myth when her female patients going through menopause often remarked that their husbands or partners had similar symptoms.
“It made sense that men were going to have reducing levels of testosterone but at different levels to women,” she said. “We all know that men can still reproduce right into their 80s whereas women’s oestrogen levels just stop and that’s the end of their reproductive years.”
Their symptoms, she said, are similar. They include: fatigue; sweats; brain fog; and joint pain but those who are overweight and have type 2 diabetes are more prone to low testosterone levels.
“Testosterone levels may be normal but the symptoms are there,” Dr. Forde said.
Andropause is a serious event in those men who do experience it. It has real physical, emotional and psychological symptoms. Erectile dysfunction is a key part and this has very unsettling effects on those affected.
Less likely to access healthcare
Dr. Forde said she previously worked with Dr. Emmet Byrne, former professional rugby player for Leinster and Ireland who heads the Vasectomy Ireland clinic in Clane, Co. Kildare, who was recently quoted in the Irish Medical Times as saying that many GPs did not fully understand the benefits of testosterone replacement therapy (TRT).
“Men in general tend to be less regular attendees at GP surgeries and less likely to access healthcare with many barriers sited in many publications,” Dr. Forde said.
Men living in rural communities are even more likely to fall into this category and so there is a reduced opportunity on behalf of the GP to engage in preventative health including their emotional health and dropping hormone levels.
“I believe that partners and spouses can help this process through open conversation and helping them access the information they need,” Dr. Forde said.