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Medico-Legal Update - An International Journal
Year : 2010, Volume : 10, Issue : 2

Print ISSN : 0971-720X. Online ISSN : 0973-5672.

Male menopause: Myth or reality

Gupta Nidhi, Asstt. Professor, Agarwal JL, Professor & HOD

Department of Physiology, Saraswathi Institute of Medical Sciences, Anwarpur, Hapur.

Abstract

The medical profession has long debated the existence of male menopause. Male menopause is a distinct physiological phenomenon that is in many ways akin to, yet in some ways quite different from female menopause. There occurs progressive but individually variable decline of serum free testosterone levels at a rate of 1% per year after age 40. It is estimated that 20% of men aged 60–80 years have levels below the lower limit of normal.

The etiology of signs and symptoms of Andropause is often multifactorial. Three hormonal systems show decreasing circulating hormone concentrations during normal aging- testosterone (Andropause), dehydroepiandrosterone (Adrenopause), and growth hormone (somatopause). It is a syndrome that characterized by physical, sexual, and psychologic symptoms. These changes become more pronounced as the male gets older. Erectile dysfunction is a characteristic feature of Andropause. Besides, other signs of virility and fertility: testicular volume, muscle mass, pilosity, daily production of spermatozoa, plasma testosterone levels, the number of Leydig cells and blood supply of the testis decrease significantly with age. Physical symptoms include asthenia, fatigue, reduced muscle and bone mass, impaired hematopoiesis. Behavioral symptoms- decreased libido, depressive mood, lack of motivation and energy, lower psychological vitality, anxiety, irritability, insomnia, decreased work and sport performances, difficulty in concentrating, memory impairment and low dominance also develop. Risk factors to the development of the above features include diabetes mellitus, hypertension, chronic alcohol consumption, obesity, and inactive life style.

This androgen deficiency state can be restored by the use of testosterone replacement therapy. For some males, the adjustment of circulating testosterone levels with replacement therapy to levels seen in young men can improve physical performance, induce a sense of well-being and restore the androgen-dependent sex drive that declines with aging. Impotence in contradistinction to impaired libido is not usually amenable to hormone replacement alone.

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Keywords

Male menopause Testosterone Dehydroepiandrosterone Serum hormone binding globulin Erectile Dysfunction Depression Hormone Replacement Therapy.

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