Andropausia

The Andropausia (from the Greek ἀνδρός, ' man ', and παῦσις, ' cessation ') or male menopause , it is The process by which man's sexual abilities decrease with age as well as other organic functions, the result of the low levels of testosterone in the body, or by the malfunction of testosterone receptors.

Just like the woman has her climacteric (menopause) the man is losing sexual potency, but without such marked cycles or such significant losses. The sexual activity of the man is not marked by regular periods as in the case of the woman, being able to have children at any time due to the production of spermatozoa. He also does not present a precise limit point. A man may have the ability to procreate until a very old age. In some men, this function can be maintained until after the age of 70 and may not even be lost over time, depending on each case.

This phenomenon has also been called male climacteric, virile climacteric, male menopause, viropause or androgen decline syndrome in the aging male, androgen deficiency in the aging male (ADAM), partial androgen deficiency in the aging male (PADAM) or androgen deficiency in male aging (DAEM). Bio-psychosocial-environmental changes converge in andropause, which are accompanied by hormonal alterations, which have been blamed for the presence of clinical symptoms and signs. Andropause is similar to menopause in women; however, there are significant differences between these 2 conditions. Men experience a slow and gradual decline in testosterone levels, and it is very difficult to determine the exact moment of its onset. On the contrary, the menopause is associated with a sharp decline in estrogen and progesterone levels, which determines a suppression of menstruation and a compromise of fertility, which, unlike men, can persist until very advanced ages. Andropause has adverse effects on physical and mental health, as well as quality of life.

In addition to the natural decline in testosterone levels due to age, it can occur in men who have undergone an orchiectomy (for example, due to testicular cancer). Even though a single testicle is normally enough to maintain normal testosterone levels, around 10% of these patients have decreased levels. And obviously it occurs in 100% of men who lose both testicles.

In many cases, men do not realize their condition, but it is obvious that this level of testosterone is decreasing over time, since the symptoms can be associated with normal states of stress. The fact is not as common as that of the woman, but it is there where the man experiences a decrease in his sexual potency.

Between 45 and 55 years of age, men can present some signs and symptoms similar to those suffered by women in the menopause stage, this is called andropause, and should be evaluated to prevent symptoms get worse.

Andropause does not imply an absence of fertility, this factor is linked to the sperm count that the person has. In addition, this does not occur in a timely manner, on the contrary, it is a fact that occurs progressively.

Symptoms

Since men do not have a well-defined or delimited period, as is the case with menopause in women, some specialists prefer to use the term androgen decline in a mature adult or late-onset hypogonadism. Men generally experience lower testosterone production as they age, although the deficit may also be due to other cogenic factors, such as diabetes.

Some of the symptoms are depression, nervousness and irritability, insomnia or fatigue, reduced libido, loss of sexual stamina, memory impairment, hot flashes, and sweating.

Epidemiology

Although the epidemiology of this condition is not well established, it is assumed that 20% of men in their sixties and 30% of those in their seventies have low testosterone levels; while 5% of men in their seventies, in addition to low testosterone levels, have symptoms, for which they are assigned the diagnosis of 'late-onset hypogonadisms.' The National Health Service (UK) considers this condition to be rare.

Description

"Andropause is a clinical picture caused by the decline in testosterone production by the testicles as a consequence of normal aging in men," defines the president of the Argentine Society of Andrology, Alberto Nagelberg. However, the specialist in endocrinology and andrology points out that, unlike menopause in women, this decline occurs slowly, continuously and progressively, so that the symptoms may, in many cases, not be noticed.

Andrologists and sexologists agree that this fault, which leads consultations in specialized clinics, can occur at any age after 40. "Testosterone production drops by around 1.2% per year after 35 to 40 years', says Nagelberg. Among the symptoms that are beginning to appear are the reduction in the frequency of sexual intercourse and erection problems.

To give a parameter of a situation to be treated, UBA Urology professor Amado Bechara exemplifies: "Patients come who say that they have not had sexual intercourse for 6 months nor have any intention of having it; or others who tell you that they had erection problems every last time they tried to have sex". In these cases, specialists detect an abnormality and start a series of studies to find the diagnosis.

There are also cases of men who never suffer from testicular dysfunction and even retain the possibility of pregnancy even at 80 years of age. The sexologist León Gindin reminds lanacion.com of the case of Charles Chaplin, who became a father at the age of 78. "This shows that not all men experience andropause; this is a big difference with women & # 34;, he clarifies. Menopause is the exhaustion of ovarian function, which is characterized by the absence of female hormones (estrogens) with cessation of ovulation and the possibility of pregnancy.

Treatments

The urologist Bechara emphasizes that the first thing is a good diagnosis, that is, it must be confirmed that there is testosterone deficiency and, in addition, the presence of other health problems that may cause it must be excluded, such as diabetes, for example. obesity, a tumor, liver or kidney problems, etc. Otherwise, money is often spent on poorly targeted treatments.

Thus, once the decrease in male hormone levels is verified, the andrologist will establish whether it is convenient for the patient to start an androgen replacement method. "The latest treatments available involve the administration of testosterone, which can be done through the daily application of a gel on the skin or the application of an intramuscular ampule every three months," says Nagelberg.