Most professionals and doctors use the term Andropause in reference to Male Menopause. Male Menopause is technically referred to as Androgen Deficiency Amongst Men (ADAM). The other names that have been used to describe it are Male Climacteric or Veropause. In females the terms menopause denotes the end of reproductive life and almost complete cessation of functioning of the female gonads and the production of female hormone oestrogen.
Similarly, Andropause denotes the cessation of male gonad functioning and stoppage of Testosterone (The Male Hormone) production. The onset of Andropause is not as clear as menopause in females. It is believed that the process leading to Andropause starts anywhere between the ages of 40 to 55 years wherein the incidence is between 2 to 5 %. The incidence beyond this age rises that it may be 90% at the age of 80 years or so. Almost all men are affected. The degree and nature of affection may very, therefore the symptoms in an andropause man may vary depending upon the organ involved (see table as under and this would further depend upon the degree of involvement of the organ.
In one of the studies in a SAARC countries maximum cases of Osteoporosis were seen in the age group of 60-64 years but the incidence recorded in the particular age group was maximum in 70-74 years i.e. 81.81%. Significant difference was observed in the level of serum Testosterone, DHEA and BMD among various groups viz a viz Osteoporosis, Osteopenia and Normal (p <0.0001). Thus, present study indicates an important role of testosterone and bone loss as measured by BMD of distal radius by ultrasonography technique
Following are the features assocaited with Andropause or Male Menopause or ‘Manopause’. These can vary in the severity and also can vary from patient to patient.
The biological changes that happen to man in this age group is directly related to the Testosterone (particularly free Testosterone) levels. A thorough understanding of male hormones like Testosterone, their physiological functions, their age-wise biological levels, identifying the degree of involvement of different organs due to deficiency of testosterone which is very important to Manage by the physician at this stage so that the so called ‘Midlife Crises’ can be averted that all men have to face.
Testosterone is the male hormone that is responsible for the development of a male child in the embryo at six weeks and since then controls further development of the embryo to a full grown male child at birth. Testosterone continues to exert its effect on the growth of the newly born male child to a boy. During this growth period, Testosterone plays its role in identifying them as boys as against girls. All this is an effect of Testosterone.
At puberty under the effect of this very Testosterone, the sexual organs gain their youthful structure. The penis takes its real size and shape and at the same time the secondary sexual characters like the pubic hair, the hair in axila , the beard, hair on the chest and the rest of the body come up. The growth of the hair of course is with in the hereditary limits. At this stage vocal cords get enlarged and the voice changes. The thickness of the skin of men and increase in the secretion of the sweat glands at this age are all under the influence of Testosterone. At this age, the Testosterone is at its maximum level in the body which effects upon the development of the bones, the muscles, the stamina so much so that the Testosterone reflects upon the behavior and the attitude of the person.
From puberty till the age of about thirty years the Testosterone continue to remain at its highest level when the man is in its highest form in the best of his qualities and proud of his manhood. The hood of man is fully indebted to Testosterone. Testosterone level from the age of about 30 years starts showing its decline and the rate of decline is variable depending upon many other factors like genetic, environmental, diet, exercise, nature, aspirations, ambitions, stress and a host of many other factors that may be beyond the scope of this book.
Depending upon the above factors and many others that are not under our control the man starts feeling his manhood getting out of hands, which we Indians pass off as the wish of God Almighty. This is the stage when the level of Testosterone in blood reduces to an extent to make him limp towards ageing which makes him prone to grave diseases particularly of the heart and brain.
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Partly the purpose of Indian Association of Age Management is to become aware of this ageing process and to suggest effective preventive steps to control the factors that cause ageing, to delay ageing and regain his manhood. If Andropause is identified in early stages, it can be treated thereby making life healthy, comfortable, enjoyable and longer. It may be a fiction today but it may be a reality tomorrow – if man does not get old at all or at least the hood of man keeps the manhood of the man for longer time.