Healthy living
Anti-ageing
HRT for the male menopause?
Tiredness, moodiness and lack of libido in older men could be the result of a male menopause or ‘andropause’, according to experts
As men age, levels of the male sex hormone, testosterone, drop. For most men this does not cause any health problems, but now scientists are claiming that for about one in five men over 65 it leads to testosterone deficiency or late-onset hypogonadism (LOH).
‘Age-related declines in testosterone are real,’ said Adrian Dobs, a specialist in male hormone replacement therapy at the Johns Hopkins University in the US. ‘If a man has signs of hypogonadism then treatment should be considered,’ he told the New Scientist.
In fact scientists are so concerned that men’s health organizations from around the world have joined forces to set out guidelines on who to screen for testosterone deficiency and how to treat it. The guidelines are published in the Journal of Andrology.
A number of studies have linked low levels of testosterone with type 2 diabetes, obesity and cardiovascular disease. The authors recommend that all men with type 2 diabetes who also show signs of testosterone deficiency should be screened. They are also keen to test men with low sex drive or erectile dysfunction (ED).
The authors of the guidelines believe that testosterone therapy may help alleviate the symptoms of the andropause. However they are keen to highlight that unlike women not all men experience the male menopause and only those men with symptoms should be considered for treatment.
In a recent study Hugh Jones, professor of andrology at the University of Sheffield, found that treating hypogonadal men who had type 2 diabetes with testosterone gel significantly improved their sensitivity to insulin, helping to control blood sugar levels. Andrology specialist, Eberhard Neischlag, who edited the guidelines, argues that a short course of testosterone may help men begin to lose weight and alleviate the symptoms of diabetes. He does not recommend that treatment should be given long term.
There have been fears that testosterone supplements increase the risk of prostate cancer but recent evidence suggests that testosterone plays a much smaller role in prostate cancer than was once thought. However treatment is not risk free and men should be checked for signs of prostate cancer before starting testosterone therapy and regularly during treatment.
At present it is generally agreed that there is not enough evidence to support a general screening programme for testosterone deficiency. However, Nieschlag would like to see an increased awareness about the symptoms of testosterone deficiency.
‘It may be depression, fatigue, a lack of interest [in sex], a broken bone – with all these things doctors should be aware that a lack of testosterone could be behind it,’ Nieschlag told the magazine.
Diabetes UK Care Advisor, Libby Dowling, said:
"There is an increasing amount of noise in research circles surrounding the connection between diabetes and levels of testosterone. The research to date, however, is inconclusive but we will certainly be keeping a close eye on any future findings.
"It is important men over 40 with symptoms of increased tiredness, depression and lack of libido visit their GP and do not suffer in silence."
Symptoms of Testosterone deficiency
- Fatigue
- Depression
- Erectile dysfunction
- Low libido
- Increased body fat
- Muscle weakness
- Osteoporosis and low bone density
More on men's health
- Male hormones mean longer life
- The low down on testosterone
- Boost your testosterone levels
- Why Mr Angry ages faster
- Men - do you want to live to 90?
- Enlarged prostate
- For men only: simple lifestyle changes
- Prostate cancer awareness
- Guide to male grooming
- Is this the secret to an active old age?
- Prostate cancer breakthrough
- Broccoli puts the brakes on prostate cancer
- Tired, fatigued or totally exhausted - what's the difference?
- Discover your energy friends and foes
- Tired all the time?
Information on this site is for interest only and is not a substitute for professional medical advice. You should consult your own doctor about any specific health concerns.
