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Andropause Often Treated With Testosterone
Barbara A. Besteni, Staff writer
A 44-year-old South Florida professional thought some symptoms were just signs of middle age.
"I was feeling fatigue and depression, especially in the afternoons," the person says. "By 8 p.m., I couldn't get off the couch. But when it was time to sleep, I couldn't."
A 40-something woman seeking medical help for those symptoms would most likely be told she was going through menopause. But in this case, the patient was Fred Thompson, an otherwise healthy man who wasn't quite sure what was going on.
"I thought maybe it was depression, but I didn't want to just start taking antidepressants," Thompson says. After seeking medical evaluation, he was diagnosed with andropause, also known as the male menopause.
What Is Andropause?
Andropause is said to affect nearly 25 million American men between the ages of 40 and 55, according to BodyLogicMD, a network of physicians specializing in natural bioidentical hormone therapy, fitness and nutrition for men and women suffering from hormonal imbalance, menopause and andropause.
"Some are surprised that there is a male correlate (to menopause) that actually has a name," says Dr. Jeffrey Thackrey, a BodyLogicMD subscriber at Lauderdale Health and Wellness, Inc. in Fort Lauderdale, Fla.
Andropause has 10 common symptoms:
# Irritability
# Sleep problems
# Diminished libido
# Erectile problems
# Muscle loss
# Weight gain
# Memory loss
# Thinning hair
# Decreased bone density
# Depression
Symptoms Vary By Patient
"Many of my patients think that they are dealing with the aging process. But many of them have also wisely done a little research on their own and have developed a more focused concern that they may be experiencing hormonal changes or decline that could be treated," Thackrey says.
Doctors say that loss of testosterone is the culprit behind the symptoms. Men begin to lose the hormone, which is crucial for building muscle and retaining memory, at a rate of 1 to 2 percent a year starting in their early 30s.
It is estimated that 30 percent of men in their 50s will have testosterone levels low enough to cause andropause symptoms.
"It is estimated that 5 percent of men ages 40 to 50 and 70 percent of men over age 70 have clinically low testosterone levels," says Dr. Paul Savage, a Chicago-based physician who treats menopausal women and andropausal men.
To confirm the diagnosis, patients are put through a battery of tests.
"First, we get comprehensive hormone profiles to assess hormone levels. We measure testosterone, estradiol, progesterone, DHEA and cortisol levels. Then I devise an individualized hormone replacement plan based on both testing and symptoms," says Dr. Michael Lee, a former OB/GYN and University of Miami professor who now specializes in treating both menopausal women and andropausal men.
"In general, the hormones for men are replaced by transdermal creams or gels, by placement of hormone pellets under the skin or by injection. The method chosen depends upon the specific hormone and discussion the patient and I have in our consultation," says Thackrey.
Thompson was able to go with the topical treatment.
"I have been on a testosterone replacement for about six months. It is a small amount of cream that I rub into my skin every morning," Thompson says.
Fast-Acting Relief
"Most patients will begin to notice a trend of improvement during the first 60 to 90 days of treatment, sometimes even in the first month. Achieving a true new hormonal balance often takes six to nine months as the body makes more subtle adjustments," says Thackrey.
Thackrey advises that men who are experiencing any of the symptoms associated with andropause should have their hormone levels tested and reviewed by a doctor who specializes in this area.
Thompson agrees.
"Get tested. Take the time to understand what your hormone levels are and discuss your symptoms with a doctor trained in this field," he says.
If tests confirm you are indeed going through andropause, don't expect your doctor to simply start handing out testosterone. Treatment includes modifying diet and fitness, which doctors say also have an effect on your hormones.
Testosterone Not Always Answer
Testosterone replacement therapy isn't for everyone.
Bioidentical hormone therapy consists of using custom-mixed formulas containing various hormones that are said to be identical to those your body produces naturally. But despite the claims that bioidentical hormones are safe, they do carry some risk.
According to the North American Menopause Society, "several bioidentical hormone products are available in government-approved, well-tested brands, but typically this term is used for hormone recipes made from a prescription by a compounding pharmacist."
Some compounds, however, have not been approved by the Food and Drug Administration and have not been tested for purity, potency, efficacy or safety.
Get Treated?
According to Savage, men who are experiencing andropause symptoms but have normal testosterone levels should not get hormone replacement therapy. Men should also be free of prostate or breast cancer for at least five years before considering the therapy.
Despite the debate as to whether or not testosterone decline requires treatment, skeptics and advocates agree that being open to the fact that men do go through something like menopause, doing research and willingness to seek individualized answers to their questions will help patients decide what's best for them.
Thompson is glad he took the time to do so.
"I have more stamina, restored sleep patterns and a healthy sex drive. I am calmer, much more alert and get less agitated. I now have an overall sense of well-being," he says.