Male “change” rare - Euro study

Friday June 18th, 2010

The male menopause exists – but it is very rare and is often linked to poor health and obesity, scientists have claimed.

Researchers at the University of Manchester led a study that found that only two per cent of middle aged and elderly men suffered from hypogonadism, otherwise known as male menopause.

They tested 32 symptoms but discovered there had to be evidence of three sexual symptoms: decrease in sex drive, erectile dysfunction and frequency of morning erection, together with low testosterone levels, to establish a diagnosis of late-onset hypogonadism.

Also linked to low testosterone levels were:

• three physical symptoms – an inability to run or left heavy objects; an inability to walk more than one kilometre; and an inability to bend, kneel or stoop;
• three psychological symptoms – loss of energy, sadness, and fatigue.

However, these non-sexual symptoms were only weakly related to low testosterone.

Symptoms usually associated with the male menopause, such as changes in sleeping pattern, poor concentration, feeling worthless, nervousness or anxiety and difficulty getting up from a chair, were rejected by the scientists as having no relevance because they were not testosterone-related.

The teams measured the testosterone levels of 3,369 men between the ages of 40 and 79 years from eight European centres. All participants were asked details about their sexual, physical and psychological health.

Lead author Professor Fred Wu, from The University of Manchester’s School of Biomedicine, said the findings, published in the New England Journal of Medicine, should lead to a change in how US physicians prescribe male testosterone therapy. Since 1999, the therapy has increased there by 400%.

“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,” he said.

“The long list of non-specific symptoms that have a potential association with testosterone deficiency makes it difficult to establish a clear diagnosis of late-onset hypogonadism.

“It is therefore important to specify the presence of all three sexual symptoms of the nine testosterone-related symptoms we identified, together with low testosterone, in order to increase the probability of correctly diagnosing late-onset hypogonadism. The application of these new criteria should guard against the excessive diagnosis of hypogonadism and curb the unwise use of testosterone therapy in older men.”

The paper, Identification of Late-Onset Hypogonadism in Middle-Aged and Elderly Men, which is part of the European Union-funded European Male Ageing Study, is published in the New England Journal of Medicine.

* Inequality is the root cause of ill health among men in Northern Ireland, a leading doctor has claimed.

Dr Ian Banks, BMA spokesman on men’s health and president of the European Men’s Health Forum, said low income was one of the main reasons behind their ill health.

Speaking as part of Men’s Health Week, he urged the men of Northern Ireland to take up exercise to improve their health and wellbeing prospects.

“In North and West Belfast, containing some of the most socially and economically disadvantaged wards in Northern Ireland, the 2002 the suicide rate for the area was 19 per 100,000 compared to10 per 100,000 for the rest of NI. This has to be halted,” he said.

“Inequality is at the root of many of our health problems in Northern Ireland. Low income disproportionately impacts on men’s health and suicide rates are appalling.”

The suicide rate for young men aged 15-24 years doubled between 1995 and 2000 to over 30 per 100,000.

Men in Northern Ireland are also notorious for delaying going to their doctor when they feel ill, which leads to the late diagnosis of serious medical conditions. Getting treatment at an earlier stage could result in an improved long term outcome for certain diseases such as diabetes or testicular cancer.

“BMA urges politicians to work with doctors, other healthcare professionals and local people to tackle inequalities, to improve the health of our whole community,” he said. “Prevention is better than cure and more cost-effective in the long term.”

The aim of Men’s Health Week, which runs until June 20, is to get as many men as possible to take up any kind of exercise. Thirty minutes a day is all that is needed, which can include such activities as walking to the shop for a newspaper or taking the stairs instead of the lift.

“Protection against heart disease, stroke, diabetes, obesity, hypertension, memory loss, colon cancer, fractures and depression should be enough to get men exercising,” said Dr Banks.

“However increasingly sedentary jobs and lifestyles, for example using the car to go to the corner shop and reaching for the remote control while watching the World Cup rather than playing football with mates are making men less active.”

Tags: Europe | Fitness | Men’s Health | UK News

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