As men start to age, their bodies also start to undergo major changes. They don't get hot flashes, but they do experience hormonal, physiological and chemical shifts that can affect many aspects of their lives. What is this phenomenon that occurs in men starting in their 40s?
You can call it aging; just don't call it male menopause.
"It's a bit of a misnomer," says Dr. Christopher Saigal, an assistant professor of urology at UCLA. "I prefer to call it ADAM--Androgen Deficiency of the Aging Male. It best reflects what is going on."
Just like women, men experience a decrease in hormone levels as they age. It simply isn't in the same way. Saigal says that starting at age 30, men start to lose about one percent of testosterone a year. It's a gradual decline, whereas women experience a dramatic drop in estrogen when they go through menopause.
"The term has a popular appeal because everyone knows it in women, but it's different," he says.
But that doesn't mean men should ignore the changes
"It's slow and subtle, so they might not recognize it," says Dr. Elliot Jacobs, a plastic surgeon in Manhattan who addresses the topic of low testosterone in his book Man Talk. "Men are usually less willing to go for routine medical checkups than women, but they should be getting tested for their hormone levels just like they get a PSA test [for prostate cancer]."
Every man is affected differently, but those who do have significantly low levels of testosterone may start to notice a decrease in sex drive, a tendency to be grumpy or sad, or tiredness. Worse, they may feel depressed or anxious, which may lead doctors to prescribe antidepressants rather than administering medically approved testosterone replacement.
'Huge placebo effect'
As awareness increases, men are starting to inquire about treatment more often, and doctors are addressing the condition more. In fact, Saigal says, between 1999 and 2002, prescriptions tripled for testosterone products such as gels, patches or injectables. But the treatment is not a cure-all: Saigal says it's just unclear whether all those treatments are actually helping.
"Not all men with borderline testosterone need treatment, but some experience something similar to having a disease, so the treatment for them has a huge placebo effect," he says.
Testosterone supplements have been shown to have both positive and negative side effects. The positive benefits are that it makes a man's bones stronger and less prone to osteoporosis or bone fractures. Testosterone has also been shown to improve a man's cardiovascular health.
On the negative side, experts say they do not know the long-term consequences of testosterone replacement. One of the main concerns is the effect it may have on the prostate, because testosterone can enlarge it. Increased testosterone also can cause blood clots and liver dysfunction. Jacobs says another problem is that it can lead to hair loss, and in the rare circumstance the testosterone can be partially changed to estrogen, which causes breast growth.
"If a man doesn't see a difference in how he feels within a few months, then he should get off of it," says Saigal. "It will take some time to figure out who are the real men who need to be treated for it."
In the meantime, experts say, it's best to see a doctor who can administer the proper amounts of testosterone. They also recommend that men do not try to supplement themselves, whether it is for treating low levels of testosterone or for activities such as weightlifting. Excessive amounts of testosterone can affect fertility, shrink testicles, cause manic anger and stunt growth.