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Researchers Identify Male Menopause Symptoms

Decreased Sex Drive and Fatigue Are Among Symptoms of Late-Onset Hypogonadism
By Katrina Woznicki
WebMD Health News
Reviewed by Laura J. Martin, MD

June 17, 2010 -- European researchers have identified physical and psychological symptoms that along with a decreased testosterone level can help diagnose “male menopause.”

Male menopause, known clinically as late-onset hypogonadism, refers to a drop in testosterone levels, which sometimes occurs as men age. Although all women experience menopause (a significant decline of estrogen) as they age, only a small number of aging men have male menopause. The study appears in the June 17 issue of The New England Journal of Medicine.

In this study, researchers from the Development and Regenerative Biomedicine Research Group at the University of Manchester in England suggest that about 2% of elderly men enrolled in the European Male Aging Study may have male menopause. The UK team based their findings on a random sampling of men participating in the European Male Aging Study. Their sampling included 3,369 men between the ages 40 and 79 who came from eight European centers.

Study researcher Frederick C. W. Wu, MD, and his colleagues surveyed the men about their physical, sexual, and psychological health. Morning blood samples were collected to assess testosterone levels. Men with pituitary or testicular diseases were excluded from the study.

Wu and colleagues identified three key symptoms related to sexual health that were associated with a decreased testosterone level and contributing to a male menopause diagnosis -- erectile dysfunction, reduced sex drive, and decreased frequency of morning erection. Six non-sexual symptoms were also identified as possibly contributing to a male menopause diagnosis. The three physical symptoms were: difficulty in engaging in vigorous physical activity, inability to walk one kilometer, and inability to bend or stoop. The three psychological symptoms were: low energy, feeling sad, and fatigue. However, the researchers noted the physical and psychological symptoms were not as strongly associated to low testosterone levels as the three sexual symptoms.

Overall, 2.1% of study group participants had testosterone levels and at least three sexual symptoms associated with criteria for late-onset hypogonadism. Researchers reported the prevalence of hypogonadism would likely increase with age; from 0.1% for men aged 40 to 49 to 0.6% for men aged 50 to 59, to 3.2% for men aged 60 to 69, and to 5.1% for men aged 70 to 79. The study also showed that men who had male menopause were more likely to have other health problems, such as being obese. 

The findings, Wu said, could help doctors identify who is at risk for male menopause and who could benefit from testosterone-replacement therapy.

"The diagnosis of classical hypogonadism is corroborated by underlying diseases affecting the testes or pituitary gland, which controls testicular function, but this well-practiced diagnostic approach is frequently found wanting when dealing with the age-related decline of testosterone in elderly men who are prone to have a significant background of non-hormone-related complaints," Wu said. "Our findings have for the first time identified the key symptoms of late-onset hypogonadism and suggest that testosterone treatment may only be useful in a relatively small number of cases where androgen deficiency is suspected, since many candidate symptoms of classic hypogonadism were not associated with decreased testosterone levels in older men."

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