Most women experience hot flashes, irritability, emotional instability, irritability, memory loss and other menopausal symptoms during the perimenopause. Many men older than 40 years old also often complain of symptoms similar to those of menopause in women, such as decreased libido, irritability, easy sweating, fatigue, and memory loss.
In fact, as early as the 1930s, a Western scholar found that some middle-aged and elderly men would experience symptoms similar to those of women going through menopause, and he named the disease “male menopause syndrome” at that time. Since then, the syndrome has been named “andropause” and “partial androgen deficiency syndrome in middle-aged and elderly men”. In 2002, the International Society for the Study of Aging Males (ISSAM) named the syndrome “late-onset hypogonadism” (LOH).
LOH is an age-related clinical and biochemical syndrome characterized by certain clinical symptoms and reduced serum testosterone levels (below the normal reference range for young healthy adult men), which seriously affects the quality of life and adversely affects the function of various organs and systems of the body. For various reasons, this disease is not widely recognized.
The core problem of this disease is the gradual decrease of serum testosterone levels in adult men with age (especially after >40 years). A cross-sectional clinical study of 1709 men in Massachusetts, USA, showed that total testosterone (TT) and free testosterone (FT) in men decreased at a rate of 0,4% and 1,2% per year, respectively. Testosterone has direct or indirect effects on all systems of the body. Testosterone deficiency can lead to abnormalities in the body’s bones, muscles, fat, blood and cardiovascular tissues and organs, as well as emotional and cognitive functions, and a range of problems in sexual function.
Declining testosterone levels in middle-aged and elderly men can cause the following symptoms.
1, sexual dysfunction: mainly manifested as decreased sexual desire, erectile dysfunction, decreased number of erections and erectile hardness at night.
2, physical decline; general weakness, easy fatigue, can not engage in heavy physical labor.
3, mental and psychological disorders: poor mental state, inattention, forgetfulness, insomnia, depressed mood, irritability, irritability, depression, etc.
4, vasodilatory symptoms: hot flashes, excessive sweating and redness, as well as panic, shortness of breath, chest tightness and blood pressure fluctuations.
5.Other symptoms: centripetal obesity, low back pain, limb and joint pain may occur. Due to osteoporosis, minor surgery can lead to fracture. Some patients may also show breast development, insulin resistance, etc. Many symptoms of type 2 diabetes and metabolic syndrome can be present.
The above symptoms can be evaluated in the form of a questionnaire (AMS scale), and blood sperm testosterone levels are also checked in patients suspected of LOH.
The diagnosis of LOH should include the following 3 aspects.
1, symptomatic screening evaluation ;
2.Serum testosterone measurement;
3, response to experimental testosterone supplementation therapy.
Correct and reasonable testosterone supplementation can significantly improve the signs and symptoms associated with androgen deficiency and restore a good life.
The benefits of testosterone supplementation therapy include
1.Testosterone supplementation therapy can improve the bone density of patients and relieve osteoporosis.
2. Testosterone supplementation therapy can increase lean body mass, improve muscle strength and reduce visceral fat.
3.Testosterone supplementation therapy can increase libido and frequency of sexual life and improve penile erectile function.
4, LOH combined with metabolic syndrome and/or diabetes, testosterone supplementation therapy can not only increase the sensitivity to insulin, improve the clinical symptoms of hypogonadism, but also improve the metabolic status.
At present, there are about 1.5-200 million men older than 50 years old in China, and a significant proportion of them have the above-mentioned “menopause” health problems. With the accelerated aging of China’s population, the problem of “male menopause” in middle-aged and old-aged men will become a major public health problem, which needs our great attention.