Andropause- Are you suffering from it?

Avinash Sharma (name changed), 41, used to often find himself tired, irritable and moody. Palpitations, depression and erectile dysfunction only made him feel worse. In fact, if you didn’t know Avinash was a man, you’d confuse his symptoms with those of a woman nearing menopause. What he was going through, however, wasn’t much different. Avinash was struggling with the male equivalent of menopause — andropause.
What is Andropause?
As men age, their testosterone level dips, triggering many physical and psychological symptoms. “It’s part of the natural ageing process. Once men cross 30, testosterone decreases about 10% every decade. Andropause is similar to menopause. One can see a decline in sexuality and energy due to the decrease in male hormones,” says clinical psychologist Seema Hingorrany.
Causes
Since testosterone is responsible for a man’s deep voice, muscle mass and facial and body hair patterns, a dip in this hormone is the main cause of andropause. Chronic stress, genetic depression and sedentary lifestyle can worsen the symptoms. Other factors that raise the risk of an early onset of andropause include higher expectations from life, poor diet, lack of exercise, high cholesterol level and smoking.
Symptoms
The main symptoms are reduced sex drive, erectile dysfunction, depression, loss of body hair, swollen breasts, palpitations, fatigue, irritability, reduced selfconfidence, poor concentration, memory loss, sleep problems, loss of enthusiasm and loss of muscle fat and fat distribution.
“Though the symptoms aren’t as severe as those of menopause, they can last for as long as 15 to 20 years. Signs can be vague and they vary, depending on individuals. You may notice decreased muscle mass and loss of muscle strength, develop a paunch and there can be a decline in your job performance as well. Some men experience these symptoms, along with a host of others, such as decreased bone density and weight gain. Symptoms of andropause can have an impact on the quality of your life. It can also increase the risk of cardiovascular disease and osteoporosis,” says Dr Parul R Sheth, a health consultant specialising in reproductive biology.
Diagnosing andropause
Diagnosis can be done by your general physician or mental health professional. After some mandatory blood tests to rule out vitamin deficiencies, routine blood examination — to check testosterone levels and prostate test PSA (prostate specific antigen) — are advised. The PSA test can identify the risk of prostate cancer. A digital rectal exam is also advised.
Treatment
“Andropause is beginning to be accepted as part of ageing. Strategies to maintain psychological balance can be taken care of by a psychologist. Hormonal therapy is also available, but has to be carefully supervised by a physician. A healthy diet and regular exercise are very important,” says Hingorrany.
Adds Dr Sheth, “Testosterone replacement therapy can be done through oral intake of medicines. Injections, patches, creams or gels are also used. Proper diet, exercise and psychosocial support are important as well. Within three to six weeks of the therapy, most men feel energetic and experience improved moods, concentration, cognition, libido, sexual performance and confidence. However, men should get their PSA levels checked as the treatment could increase the risk of prostate cancer.”
Can it be prevented?
“You can’t prevent a natural process. But incorporating lifestyle changes such as optimal diet, regular exercise and stress-management will help. Avoid smoking and reduce alcohol intake. Consume foods rich in testosterone like urad dal, garlic, green vegetables and cow’s milk. Yoga is helpful, especially the Surya Namaskar, which is known to balance hormones,” adds Dr Parul.
At what age does it occur?
An early onset of andropause is seen these days. “Earlier, I would see cases between the ages of 48 and 65. But now, it has come down to 38. Reasons include high stress levels, environmental depression, smoking, substance abuse, binging on junk food, obesity, etc,” says Hingorrany.
Shy to talk about it?
“In India, most people are not aware of it. A majority of men, after the age of 50, do show some physical and psycho-sexual changes. But they don’t want to talk about it and thus, andropause goes under-diagnosed,” says Dr Sheth.
Adds Hingorrany, “I have seen during my practice that Indian men are not much aware about the causes and symptoms. Till they come to us, they feel they are suffering from serious physiological problems or depression. Also, Indian men are shy to discuss their sexual problems. Not much is written about it either.”
Did you know?
Unlike the more dramatic hormone plunge that occurs in women during menopause, sex hormone changes in men occur gradually, over a period of many years. Andropause is natural, but a healthy diet and healthy mind can ensure that the symptoms don’t worsen. Low testosterone levels, in about 40% men, occur between the ages of 40 and 55. It can last for 15-20 years. By the age of 70, the dip in a man’s testosterone level can be as much as 50%. Research shows high cholesterol levels and smoking can raise the risk of an early onset of andropause.