Weren't your 20's great!You were the Man!You could attract the ladies with the wink of an eye, a tight pair of jeans, and just the flash of an electric smile. With a reasonably clever pick-up line, you were 'In, like Flynn'.
Fast forward to the present, and things may have changed for you.You've lost your fearless and powerful "Swagger" that defined you as a young man.Your body has changed. You're not as lean and buff as you used to be.Your "6-pack" has been traded in for a Beer gut. Mentally and physically, you don't feel as well as you used to. You may be depressed and irritable. You have little motivation and energy, and you may struggle just to get through another day at work. To make matters worse, your sexual function, libido, and performance is inadequate, unsatisfying for you and your partner, and embarrassing for you. The morning erections have disappeared.You become phobic and start to avoid sex and intimacy.Your partner notices, and thinks you may be impotent.
A lot of men think that this is a normal process that all men go through. It is a part of aging.You rationalize that sex is less of a biological drive for a man in his 30's and beyond. This subject is rarely the type of thing you can discuss with your partner or with your buddies. With this thinking, couples in effect sentence themselves to a life devoid of essential sexual intimacy and fun, failing to recognize a medical issue which could be diagnosed and treated. Truthfully speaking, a healthy man can enjoy the full range of sex throughout his entire life. Yes, a 70-year-old man may have more "swagger" and "game" than you do.
You haven't lost your 'Mojo'.Instead, what may be happening to men who can relate to this set of symptoms and circumstances is Andropause or the 'male' version of menopause. Andropause is characterized by the loss of testosterone, the hormone in the androgen hormone class that is responsible for the secondary-sex characteristics that occur in puberty to make Men look and act like men.For unknown reasons, the level of testosterone drops in men starting as early as age 35, and dropping at a rate of 1-1.5% per year.That's 10-15% for every decade past 30. Unlike the precipitous fall in estrogen levels that women experience in menopause, the gradual loss of testosterone may take a few years to make its impact on men.When it does, in many ways, the symptoms resemble that of a menopausal woman. The key difference is that whereas menopause is the end of the reproductive phase of a woman's life, Andropause does not herald the end of a man's reproductive life or ability.
Molecular Structure of Testosterone
The Symptoms of Andropause
The symptoms of Andropause include, but are not limited to, fatigue, depression, irritability, nervousness, memory impairment, loss of concentration, loss of confidence, insomnia, hot flashes, and sweating.Sexual symptoms include reduced interest in sex, erection problems, and failure to achieve orgasm.Outside of these symptoms, andropause may also lead to the intensification of pain for chronic pain sufferers.Physically, a decline in testosterone levels may include changes to the body habitus and body fat and muscle composition. It may promote insulin-resistance resulting in changes in how the body stores fat, leading to 'Buddha belly', 'beer gut' and the 'man-boob' look.
The recognition of Andropause as a clinical entity is not new.The impact of low testosterone in aging men was first brought to clinical attention by Dr C. G. Heller (Heller& Myers) in a 1944 article in the Journal of the American Medical Association. In this report, the authors described the impact of low testosterone in aging men and found that the symptoms dramatically improved with supplementation of testosterone.In the US, many physicians are aware and recognize the impact of declining testosterone, some by its more clinically acceptable names, ie Symptomatic Late-Onset Hypogonadism (SLOH) and Androgen Deficiency in Aging Males (ADAM).
What can you do if you think you are suffering from andropause?
First, see your physician.He or she will be aware of this condition. Through blood tests, they may be able to confirm the presence of low testosterone and may be able to rule out any other condition that may be responsible for some of these same symptoms.Most men who may be in this age group can use this opportunity to be screened for prostate cancer (PSA blood test and digital rectal exam), which is still a leading killer of men in America. If low testosterone is confirmed, typically below 250 nanograms per deciliter, your doctor may initiate treatment to supplement your levels with testosterone injection, androgen cream or gel.Your primary doctor may instead refer you to an endocrinologist, internist or urologist to have this problem addressed.The goal will be to bring the testosterone level into balance that would be normal for your age or, as some anti-aging physicians believe, into the higher ranges for the average 30-year-old man.In most cases, the mental, physical and sexual symptoms recede or disappear.Life gets really good again. The goal is not, however, to bring the levels higher than what would be normal or physiologic, as occurs with the illicit and potentially harmful use of testosterone in bodybuilding.
Talk to your Doctor about Andropause.
As with any medical treatment, there are potential risks when using testosterone, and your doctor will discuss these risks with you.A significant concern is the role that testosterone may play in a subtype of prostate cancer.This concern is valid, but some doctors believe and a few studies have shown that the risk of prostate cancer may be higher in low-testosterone males, and that the risks can be lowered with testosterone treatment in those individuals.The key is balancing the known and suspected risks of treatment with those of not being treated.
What's your next move?Get Tested. Get Treated. Then, Get after it!
Dr. Harvey Jenkins is a Harvard-trained Orthopedist and Spine specialist, practicing in South Oklahoma City.He is a Wellness Blogger and is also Owner and Medical Director of BodyTrends, the ElectroSpa in OKC.
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