Andropause: Androgen Deficiency - Male Menopause - fact or fiction?
The reasons that the 'male menopause', otherwise known as the 'andropause', is still neither recognised nor treated by the majority of general practitioners, urologists or even andrologists can be grouped together as historical, medical and image problems.
Early treatments resulted in the dubious "monkey-gland" image of testosterone treatment which persists to this day, and the oral form methyl testosterone, which unfortunately is toxic to the liver and heart, and has adversely colored the thinking of physicians.
Total testosterone, which is all that is usually measured in men complaining of Andropausal symptoms, is only low in relation to the standard laboratory "normal range" in 13% of cases. However, more detailed blood analyses show that the bio-available Testosterone as represented by the the Free Androgen Index (FAI) is decreased in 74% of cases.
The name of the condition, even if dignified with the medical title of Andropause, appears an unacceptable threat to masculinity, and the condition is often incorrectly confused with the psychological traumas of the "Male Mid-life Crisis".
This is the most common presenting problem in male sexual dysfunction clinics and peaks at the time when the andropause appears.
Man's ability to have an erection is actually a recurring miracle of hydraulic engineering. Though it is difficult to say precisely what part testosterone plays in helping to produce erections, it certainly both primes the penis and triggers the chain of events which bring an erection about. It is surprising, but gratifying, how often when adequate testosterone therapy is given, all the symptoms of the andropause disappear within a few weeks or months, including erectile difficulties, particularly when other factors contributing to its onset or continuation are dealt with.
Even though it is more difficult to restore function than desire, unless the source of the problems is obviously psychological or mechanical, it seems logical to investigate the testosterone balance of the patient, and restore it to normal as the first stage of treatment. Even if erections are not greatly improved by this alone, libido and confidence usually are. Recent experience has proven that sexual enhancement products combined with Testosterone replacement medicines provide relief for most men reporting problems with sexual performance.
The First Steps .... what you should do if you think you are Andropausal or have low hormones:
1.) Seek the guidance of our physician associates, and tell him/her your symptoms, which are the most important factor in establishing a diagnosis.
2.) A blood profile may be suggested, which needs to include not just total testosterone, but a test for free active testosterone, which is best obtained in the form of the Free Androgen Index (FAI) by calculation from the Sex Hormone Binding Globulin. Where this is not available, the free testosterone and the free-and-weakly bound testosterone can be used. The symptoms you are suffering are more important than the lab data, as accepted reference ranges vary widely.
If you are over 50, it is advisable to include a Prostate Specific Antigen test, and is mandatory before and after starting on testosterone treatment.
3.) You may find interesting information by doing a search under "Andropause" or "Male Menopause" on other web sites for further information.
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