Do men go through that change of life experience like women do? Is the 'menopause' or 'climacteric' isolated only to middle-aged women? Are women the only ones that suffer from these terrible hot flashes and mood swings? What about men?

Andropause.

Andropause is a clinical syndrome seen in men, associated with advancing age and manifested with symptoms related to lowered testosterone (male hormone) levels.

How common is andropause?

The prevalence of this condition is six to 12 per cent in men between 40 and 70 years of age. Unfortunately, only 10 per cent of men are treated as symptoms may be trivialised or ignored. 15-30 per cent of diabetic or obese men experience andropause.

Why does andropause occur?

The symptoms seen in andropause are due to a decline in testosterone levels. Testosterone declines at a rate of one per cent annually between the ages of 40 and 70 years. However, the decline may be seen earlier. Remember that testosterone is a hormone produced by the testes which are located in the scrotum.

Testosterone: the male hormone

Testosterone has many beneficial effects in men and this is not isolated to sexual functions only. It helps in the production of facial and body hair. It maintains overall strength and muscle mass. It helps in the production of red blood cells in the bone marrow so that men aren't anaemic. It maintains bone density and strength and reduces osteoporosis. It is responsible for the sex drive and libido. It aids in memory and cognitive functioning. Testosterone helps in the development of the penis and aids in sperm production. Since testosterone has all these important functions, andropause manifests with abnormalities of these functions.

What are the common symptoms of andropause?

Typically, men with andropause have a reduced libido or sex drive and have diminished interest in sexual activity. They may notice that their spontaneous and stimulated penile erections are fewer and weaker. Less commonly, some men notice breast swelling and loss of body or facial hair. It may be associated with hot flashes, similar to those seen in women in menopause. They get an intense feeling of heat to the face and upper body, which lasts for a few seconds or minutes. Andropause may be associated with male infertility. Many men with andropause have reduced energy and motivation and express depressive symptoms. They may have poor concentration and memory and are always falling asleep. Weight gain and obesity may be associated with this condition.

Andropause and the heart

Andropause can put men at risk for cardiovascular diseases such as a heart attacks. This is because of its association with obesity and high cholesterol and sugar levels. This is an area of great research interest.

Andropause can be identified and treated. It is a condition that affects men and their partners psychologically and emotionally. Men should not suffer in silence. Let your doctor know if you have any of the symptoms mentioned.

Next week we will discuss the methods of treatment of andropause.

Dr Belinda F Morrison is a urologist and lecturer at the University of the West Indies. Contact her at belinda.morrison02@uwimona.edu.jm.