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Thursday, March 25, 2010

Buletin Akademik: Andropause

Assalamualaikum dan salam sejahtera


The Andropause is the time in a man's life when the hormones naturally start decline usually during their late forties or early fifties. This decline continues into the eighties. Many have questioned whether the male menopause is more myth than reality. However, like women undergoing menopause, the decline in hormones in men result in them suffering from symptoms of the Andropause. However, like the menopause, symptoms of Andropause can vary from person to person.

Between the ages of 50 to 70, some men report symptoms such as erectile dysfunction (failure to achieve an erection), general tiredness, mood changes, night sweats and sometimes palpitations. Most men attribute erectile dysfunction to be the most significant event of the Andropause. Apart from erectile dysfunction, mood changes can take place too. Some patients of might have complained of nervousness, irritability and even depression. Other patients undergoing andropausal changes report the feelings of wanting to be closer to family and friends. Men often focus too intently on their career, money and power in their earlier life, often neglecting family and friends. In the andropausal years, men and take on a more "maternal" role, as if transitioning to become more motherly than fatherly. They become more concerned about their friends and family, as if regretting their former attitudes. It is interesting that many patients do not sense these changes in themselves, but rather it is women that notice this and tell that he is undergoing "the menopause"!

In andropausal men, night sweats and palpitations occur because of an overactive autonomic system in response to falling testosterone levels. To assess for hypogonadism, which is in part the clinical basis of the Andropause, the doctor will check for physical signs in men including hair loss particularly in the armpit and genitalia. Psychological tests may be carried out to rule out depression and other mood and cognitive changes.

Throughout the life of a male there are several psychological issues that he struggles with, and these challenges are often amplified during the time of the Andropause: -

1. His sexuality
2. His emotions
3. His mind
4. His courage
5. His productivity
6. His personality
7. His character
8. His boyish behaviors

In the andropausal years the mind becomes less sharp and nimble. The older male becomes less swift in mental calculations and his judgment is not as accurate as before. In more severe cases, the memory gets impaired too, and with time, dementia may even set in.The andropausal man may relive his childhood days, often to the amazement of his partner or spouse! The mischief may be an extramarital affair, a new red sports car, a sudden passion for toy train sets, riding a bicycle, which he hadn't done for years, and so on. Sometimes of these childish acts may even be mistaken for Alzheimer's dementia!

The Andropause is beginning to be accepted as part of aging. Coping strategies are important. Hormonal therapy for the symptomatic is available today but has to be carefully supervised by a physician.


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