Low testosterone, age, signs in men

Andropause is a decrease in testosterone levels in men. And it is not without consequences.. At what age does it occur? What are its distinguishing signs? treatments? Answers with Dr. Sebastian Bailey, urologist.

Contrary to what one might sometimes think, Andropause In men it is not the same as menopause in women. Indeed because it is not unsystematic ; Then because it is gradual. Andropause is not exactly the equivalent of menopause because there No decrease in fertility associated with this decrease in testosterone Dr. Sebastien Bailey, a urologist in Paris confirms. How do you know him? Especially at what age? What do you take?

Definition: What is andropause?

Andropause, or “age-related androgen deficiency,” refers to both Physiological symptoms related to an abnormal decrease in testosterone secretion in menusually from 45 years old. Andropause occurs outside of any pathological context that could explain the decrease in androgen secretion. It changes the quality of life and has an impact on the function of many organs.

At what age does menopause begin?

The risk of andropause increases with age, especially after the age of 60. “Its incidence is about 12 new cases/10000/year, and its prevalence is 6% between 30 and 80 years It increases with age (5% at age 50 .).10% at age 60, 15% at age 70, 26% at age 80)Urologist Stephane Drupe reports in an article published by the Urofrance Association in 2021. In some men, it can settles down at the age of 20. Not all men have andropause, and not necessarily at the same age.

What are the signs of andropause?

A drop below normal testosterone thresholds can result in a decrease in male fertility, disturbances in sexual function (loss of sexual appetite, erectile problems), a decrease in muscle formation and bone demineralization, disorders of fat metabolism (weight gain) and cognitive impairment. . Symptoms and signs that reflect a lack of testosterone are not specific and can be encountered during normal aging and depressive syndromes. They do not necessarily all have to be present at the same time and they do not all have the same intensity.

Symptoms summary:

  • Decreased sexual desire.
  • Decreased or absent erection and nocturnal awakening reflex (involuntary)
  • Erectile dysfunction (longer erection, faster fallout)
  • Sweating episodes independent of physical exertion.
  • hot flashes
  • More frequent stress, more strenuous physical recovery after exertion.
  • Sleep disorders.
  • Increased nervousness and frequent irritability.
  • tendency to depression.
  • decrease in muscle mass;
  • Increased abdominal circumference.
  • Osteoporosis.
  • More muscle and joint pain.
  • Retreat in hair.

What are the causes of andropause?

Only 2% of testosterone circulates freely in the blood. In fact, it mostly binds to two plasma proteins: albumin (weakly bound) and SHBG (strongly bound). The decrease in testosterone secretion is due to aging on the one hand, and a high level of SHBG or “sex hormone-binding globulin” on the other. This increase has the effect of removing usable testosterone from the bloodstream: it thus enhances andropause and its physiological manifestations.

Prostate treatments can lead to andropause

An increase in the level of SHBG is also associated with various diseases (eg cirrhosis, hyperthyroidism) and taking certain treatments (eg anticonvulsants). Antiandrogens used to treat metastatic prostate cancer You may also participateDr. Sebastian Bailey adds. Before determining that this is also the case for some treatments for prostate adenoma (dutasteride, finasteride) and hair loss treatments (Finasteride at a lower dose).

A blood test confirms the diagnosis of andropause:

Testosterone Dosage (blood test in the morning on an empty stomach)

Complete hormonal balance If the testosterone level is low (dosage of total, free and bioavailable testosterone, SHBG, LH and FSH, prolactin.

What treatments for andropause?

Treatment depends exclusively onTestosterone management. There are several offers: injection (intramuscular), tablets, transdermal gel, patch. Erectile dysfunction can be the subject of specific complementary treatment by sildenafil, vardenafil or tadalafil. Testosterone therapy includes a Prostate examination before (dose PSA in particular) and regular monitoring of it. It is also recommended thatAdopt a healthy lifestyleAnd the Have regular physical activityAnd the lose excess weightQuit smoking and reduce alcohol consumption. Take testosterone Contraindicated in case of breast cancer, prostate cancer and history of sexual delinquency. Age is not a contraindication.

Thanks to Dr. Sebastien Bailey, a urologist in Paris.

Sources:

Andropause (age-related testosterone deficiency syndrome) 7. Author: Stefan Drupe. 2021

Menopause and Andropause- Pr Jacques Tostain, The Practitioner’s Review, 2007.

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