Consider the following terms: male menopause, andropause, viropause, the male climacteric and Androgen Deficiency in Aging Men — or as some manage to refer to it with a straight face, ADAM. All of these terms presume to describe the decline in testosterone among middle-aged men. Now, it seems, it’s not enough that Adam blew his tenancy in the garden. He’s also the eponym for an embarrassing male affliction.
BUT HOLD ON. Don’t the names of this condition themselves give you pause?
The idea of a male “menopause” is preposterous, as the Greek roots of the word add up to “menstruation pause.” Let’s forget that the Latin “viro” means poison (Ah, the source of that popular affliction, testosterone poisoning). And andropause means “masculine pause.” But what’s up with this notion of a “pause” in hormone production? Is that to say that, after a brief time out, a vacation from testosterone (poisoning, if you must), production suddenly cranks back up to its pre-early-geezer levels?
“Male climacteric” seems equally misleading with its implication that one day and quite suddenly, buddy, it’s going to be all over for you. ADAM comes closest to accurately describing the condition. But left hanging is the question: Does it really exist?
Possible Symptoms of Andropause
- Irritability
- Concentration problems
- Anxiety
- Depression
- Weight gain
- Hair loss
- Sleep disturbances
- Lackluster libido
- Difficulty maintaining an erection
The question is being asked more often these days, primarily because there is now a topical drug, AndroGel, that administers gradual doses of the hormone. AndroGel went on sale last summer, and exaggerated claims for its need followed. Remember what happened when Viagra became available? Experts were quoted as saying that half of all men suffered from impotence, a preposterous figure. Now, some researchers are saying that half of all men over 50 suffer from ADAM, andropause or whatever you want to call it — more proof that if you create a drug, the condition will follow.
Although many people are aware of testosterone’s importance in maintaining muscle strength and sexual function, the hormone also has important effects on the brain, skin, liver, kidneys, blood, bones, heart, prostate and cholesterol levels.
The symptoms commonly associated with ADAM, not surprisingly, range from the psychological to physiological. Andropausal men, researchers say, suffer from irritability, indecisiveness, anxiety, fear, depression, loss of self-confidence and joy, inability to concentrate and feelings of loneliness.
Physical symptoms include taking longer to recover from injuries or illness, gaining weight, difficulty reading small print, loss of or thinning hair, and sleep disturbances.
Of course, the greatest concerns are sexual: ADAM is thought to be manifested by reduced interest in sex, increased anxiety about losing sexual potency, increased fantasies about having sex with a new and younger partner, more relationship problems, and difficulties maintaining an erection during sexual activities.
RESEARCH LACKING
One big problem with this picture: Researchers have never been able to nail down a cause-and-effect relationship between testosterone levels at midlife and these myriad symptoms.
Researchers do know, though, that as many as 80 percent of cases of erectile dysfunction have a medical cause such as diabetes, cardiovascular disease, neurological disorders, surgery (such as prostatectomy) and trauma.
All of which raises an important question: Is it worth the risk — and there are risks in testosterone supplementation — for men to take hormone therapy?
Supplementation has been linked to strokes. “And we don’t yet know the long-term risks,” says Dr. Lisa Tenover, a geriatrician at Emory University in Atlanta. “That’s where I’m most concerned.”
Fortunately, there’s a solution to this problem, whatever you want to call it. Those few men who suffer from abnormally low testosterone levels can most likely benefit from supplementation. The vast majority of the rest of them can satisfactorily be treated with Viagra, the wonder drug.
And for an hour or two, at least, andropausal men can restore Adam to the garden.