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When women reach the end of their child-bearing years, their bodies go through menopause, as they stop producing the hormones needed to conceive and bear children. There is evidence that men can experience something similar when they begin to produce less testosterone as they approach middle age.
While not currently recognized as a disorder by the World Health Organization, andropause refers to the gradual drop in testosterone to below therapeutic levels, as experienced by some men in middle age. Testosterone is crucial for sex drive and stamina, bone formation, liver function and other metabolic functions. There is treatment for this disorder, but it is somewhat controversial.
Andropause, also known as ADAM (androgen deficiency in the aging male) and PADAM (partial androgen deficiency in the aging male), generally begins after age 30, with testosterone decreasing very slowly over the next four or five decades. Studies have shown that approximately 20% of men in their 60s and 50% of men in their 80s have evidence of testosterone deficiency.
Symptoms of andropause include loss of lean body mass and increase in fatty tissue, less muscle, decreased bone density, decreased body hair and skin thickness, diminished libido, reduced energy, increased irritability and depression, impaired sleep and a slowing of cognitive functioning.
The primary difference between menopause and andropause is that menopause happens suddenly, and is complete within a relatively short time. This abrupt shift in hormones in women can be extremely uncomfortable, leading to a variety of symptoms.
In men, the change in testosterone levels is harder to determine. The level of testosterone may be significantly different between one man and another, and the rate of decline may differ as well. Because the change in testosterone levels takes place over decades, rather than just a few three to five years, as women experience, it is much harder to both diagnose and measure. This is one of the primary reasons researchers debate the diagnosis.
Testosterone regulates mood, among many other functions. The gradual lessening of testosterone levels may lead to irritability, sadness, loss of interest in things once thought pleasurable – in other words, depression.
All of this takes place, of course, during the period in a man’s life when there are other significant changes and stressors. These are the years where men’s education is over and careers are locked in – for better or worse. These are the years where men are no longer parenting children completely dependent upon them, but rather children who can talk back. These are the years when the needs of paying the mortgage, building college funds for the kids and setting aside money for retirement are in conflict. These are also the years when the health of aging parents can begin to fail.
Men who seek treatment for depression during these years are more likely to seek psychiatric help. Antidepressants may help, as might psychotherapy.
Men might consider also seeing their physicians, to be evaluated for the possibility of low testosterone levels. Testosterone replacement therapy has proven, in studies, an effective treatment for depression.
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