European researchers have identified a few physical and psychological symptoms accompanied by low levels of testosterone, which will enable doctors to diagnose male menopause or late-onset hypogonadism. Male menopause refers to a reduction in testosterone levels, which is a result of aging. Contrary to female menopause, male menopause is not a commonality among all males.
According to the results of this study, published in the The New England Journal of Medicine, about 2% of elderly men who participated in the European Male Aging Study show symptoms of male menopause. Researchers from the Development and Regenerative Biomedicine Research Group at the University of Manchester in England randomly gathered 3,369 men between the ages of 40-years-old and 79-years-old for the study. The physical, sexual, and psychological health of the participants were observed, and blood samples were collected to assess their testosterone levels.
Frederick C. W. Wu, MD, and his colleagues, identified three sexual symptoms that indicate a possible diagnosis for male menopause, including:
- erectile dysfunction
- low sex drive
- decrease in morning erections
Researchers also identified six non-sexual symptoms, which are possibly associated with the diagnosis of male menopause. The these symptoms are:
- Difficulty to perform physical activities
- Inability to walk one kilometer
- Inability to bend over
- Low energy levels
- Feeling sad
The observations show that the non-sexual symptoms, including the physical and psychological symptoms, are not strongly associated with low testosterone levels, when compared to the sexual symptoms.
Out of the 3,369 participants, 2.1% had low testosterone levels and three sexual symptoms associated with the criteria for male menopause. According to researchers, the prevalence of hypogonadism will increase with age. For men between the ages of 40-years-old and 49-years-old, the prevalence of male menopause is thought to increase by 0.1%. For men between the ages of 50-years-old and 59-years-old, the increase is 0.6%. For men between the ages of 60-years-old and 69-years-old it is 3.2%, and for men between 70-years-old and 79-years-old, it is 5.1%. The results also revealed that men who experience male menopause were more prone to other conditions, like obesity.
According to Wu, the findings of the study will help doctors to identify men who are at an increased risk of developing male menopause. They will be able to make the distinction between who needs testosterone-replacement therapy, and who doesn't.
As per the classical approach, hypogonadism is corroborated with medical conditions that affect the pituitary glands, which control the function of testes. This diagnostic approach may not always be practical, especially in age-related declines of testosterone. According Wu, this is the first study to identify the key symptoms of late onset hypogonadism. It also suggests that testosterone therapy may be useful only in few cases where androgen deficiency is suspected. Many of the symptoms of hypogonadism were not associated with decreased levels of testosterone.
Researchers also compared the differences in the levels of testosterone between men with symptoms, and men without any symptoms. They found that there was only a marginal difference, which shows that the association between symptoms and testosterone levels is weak. Yet, the researchers caution that there might be a bias, as symptoms were recorded based on the patient’s recall.
According to Wu, there is a tendency to over diagnose male menopause; the number of people opting for testosterone therapy increased by 400% in U.S. Using the criteria presented by the study will help to prevent excessive diagnosis of male menopause and also curb the option of using testosterone therapy in older men, adds Wu.
A new study conducted in the U.S. that was published in the International Journal of Clinical Practice showed that there is a high prevalence of hypogonadism among older men and researchers expect the number to increase, as men are living longer than they used to. The article also reported a link between male menopause and other chronic health problems, including obesity, type 2 diabetes, high blood pressure, osteoporosis, and metabolic syndrome, which is an endocrine disorder that can increase the risk of diabetes, heart disease, and stroke.
According to Christopher Saigal MD, MPH, an associate professor of urology at the University of California, Los Angeles, suggests that it was a successful study in that many of the complaints presented are associated with low levels of testosterone. “The authors found that some sexual symptoms and a lower self-reported vitality were consistently associated with low testosterone levels” tells Saigal.
Saigal added that it is known that the levels of testosterone decreases by 1% every year after a man reaches 30-years-old.The long-term effects of medications and the benefits of testosterone supplementation are also unknown.