When it involves menopause, many individuals assume that solely ladies will expertise it.
But over the previous couple of a long time, there was rising recognition of a so-called “male menopause” or andropause, which usually refers to male androgen deficiency or testosterone deficiency syndrome.
Testosterone deficiency syndrome, additionally recognized as late onset hypogonadism, is a situation in which males don’t produce sufficient testosterone, which is a significant male hormone or androgen.
This outcomes in psychological, emotional and sexual dysfunction, and will have an effect on a number of organ methods, ensuing in critical well being penalties.
In the previous, it was thought that sufferers with testosterone deficiency syndrome have been usually older males, but in truth, it might occur in males of various age teams, together with younger and middle-aged males.
Not restricted by age
Testosterone performs a key position in male libido, muscle mass, and psychological and bodily energy.
Many middle-aged males might need varied signs of testosterone deficiency, but they might not be conscious of the trigger or select responsible it on different causes, such as ageing.
Indeed, from one other standpoint, the time period “andropause” will not be essentially the most correct time period for sufferers with testosterone deficiency, as decreased testosterone levels aren’t an inevitable consequence of ageing.
But it’s price noting that testosterone levels do usually decline with age, as older males are inclined to have decrease blood testosterone levels.
Testosterone deficiency largely happens between the ages of 45 to 60, but in line with the information, the proportion of older folks can be increased.
For males aged 45 and over, almost 40% are affected by testosterone deficiency syndrome.
As for males over 80 years outdated, as much as half may have this syndrome.
You may ask, why are younger males affected by testosterone deficiency syndrome as well?
The younger pattern of testosterone deficiency syndrome is often associated to ailments; the unhealthy life-style of younger folks, together with poor weight loss plan, smoking, alcoholism and lack of train; and/or drug use, such as the abuse of painkillers.
Diseases that may have an effect on testosterone levels embody weight problems, liver illness, kidney illness, diabetes, hypertension, excessive lipid (fats) levels, psychological sickness and AIDS (Acquired Immunodeficiency Syndrome).
Signs and signs
Symptoms of testosterone deficiency embody:
- Decreased libido or sexual drive
- Difficulty getting and sustaining an erection
- Difficulty concentrating and making selections
- Increased physique fats and muscle loss
- Loss of bone density
- Depression
- Irritability
- Anxiety
- Restlessness
- Poor work efficiency
- Impaired reminiscence
- Inability to pay attention
- Fatigue
- Lack of stamina and bodily energy
- Insomnia or sleepiness
- Loss of urge for food
- Constipation
- Skin atrophy, and
- Lower again ache.
As for bodily indicators, there can be a lower in muscle mass all through the physique; a rise in subcutaneous fats, ensuing in the affected person showing fatter, particularly across the stomach; hair that begins to show white and develop into sparse; tooth and physique hair that begin to fall off; and the shrinking of testicles; as well as indicators of breast enlargement in some sufferers.
In addition to bodily and emotional modifications, testosterone deficiency can result in the onset or exacerbation of varied ailments.
When a person has low testosterone levels, there’s a better danger of coronary heart illness, most cancers, hypertension, diabetes, excessive ldl cholesterol levels, osteoporosis, anaemia and dementia.
Diagnosis and therapy
In many instances, the analysis of testosterone deficiency in a affected person should first be primarily based on medical manifestations and signs.
Then it’s essential to test whether or not the testosterone stage is low.
If the affected person’s signs solely enhance throughout therapy, it confirms that the affected person has developed testosterone deficiency syndrome and desires testosterone substitute therapy.
The purpose of testosterone substitute remedy is to enhance the affected person’s signs and normalise his testosterone levels.
As of now, there are two medically-proven testosterone therapies accessible in Malaysia.
One entails a gel preparation, whereas the opposite is injected.
The gel preparation is utilized on the pores and skin of the higher arms, shoulders, internal thighs or stomach.
The testosterone is then absorbed via the pores and skin into the physique.
The affected person mustn’t bathe or bathe inside an hour of utilizing the gel formulation to make sure that the testosterone is absolutely absorbed by the physique.
It ought to be used day by day in order that the affected person’s testosterone levels are secure, just like the physiological blood levels produced by the testes.
The use of gel preparations ought to often be the primary alternative for sufferers.
Meanwhile, the opposite kind is given by intramuscular injections each few weeks or months.
Depending on the frequency of injections, signs might fluctuate between every dose.
The gel formulation has fewer unwanted effects and has been accepted by the US Food and Drug Administration (FDA).
However, sure testosterone injections might trigger unwanted effects such as pulmonary microembolisms – these haven’t been accepted by the US FDA up to now.
Benefits and cautions
Testosterone substitute remedy serves to assist enhance physique composition by constructing muscle and decreasing fats mass, together with whole physique and visceral fats.
It can even assist enhance insulin sensitivity, thereby addressing metabolic syndrome and decreasing the danger of kind 2 diabetes.
In addition, it might enhance the affected person’s sexual operate; temper, together with signs of melancholy; and power and high quality of life.
In phrases of illness, testosterone supplementation can enhance anaemia, and scale back demise from all causes, together with coronary heart illness.
Testosterone supplementation will not be appropriate for sufferers with prostate most cancers, sleep apnoea or polycythaemia (the place haematocrit or haemoglobin is elevated in the blood).
Therefore, sufferers should have their prostate-specific antigen (PSA) levels checked previous to starting testosterone substitute remedy.
According to some early analysis, the usage of testosterone dietary supplements appeared to advertise prostate most cancers; nevertheless, there isn’t a proof of this in the most recent analysis.
Nevertheless, sufferers are suggested to have their PSA levels checked often after they begin taking testosterone.
During the course of therapy, the physician may even often test the affected person’s haemoglobin and haematocrit levels.
These blood assessments will assist to see whether or not the affected person’s blood has thickened, as haemoglobin and blood cells are extra liable to irregular rises in stage with sure kinds of injectable testosterone.
In common, modifications because of the therapy will occur inside three to 6 months after therapy has commenced.
Patients have to be conscious that testosterone supplementation remedy is a lifelong therapy, and testosterone supplementation can result in a lower in the quantity of testosterone naturally produced by the physique.
Don’t ignore signs
It is necessary to reiterate that testosterone deficiency will not be an inevitable phenomenon of ageing.
In quick, when a person, particularly an aged man, experiences testosterone deficiency signs, completely different well being issues might occur as a end result.
Therefore, its existence should not be ignored.
It is really helpful to hunt skilled recommendation from a physician as quickly as doable when you’ve got signs of testosterone deficiency.
Get the correct therapy to enhance your well being and high quality of life.
Dr Tay Hui Sian is a advisor geriatrician. For extra data, e-mail [email protected]. The data offered is for instructional and communication functions solely, and shouldn’t be thought-about as medical recommendation. The Star doesn’t give any guarantee on accuracy, completeness, performance, usefulness or different assurances as to the content material showing in this text. The Star disclaims all duty for any losses, injury to property or private harm suffered immediately or not directly from reliance on such data.
