Definition
Just as the menopause is called the sunset of the fertile age of women, the andropause marks the physiological exhaustion of reproductive abilities in the elderly man. However, unlike the female condition - a very precise and defined phase of a woman's life - the andropause does not always stand out from a real stalemate of procreative potential: every man reacts subjectively to the delicate period he is facing, and only some completely lose their fertility.
- More than of andropause, it would be more correct to speak of "syndrome of partial deficiency of androgens in old age"
Causes
The cause of andropause essentially lies in the physiological decrease in testosterone levels in the blood; however gradual and slow, the hormonal decline is the more important the greater the weight of the man. The decrease in serum levels of the male hormone par excellence drops by 1-2% a year, starting from 25-30 years; calculating rapidly, it is observed that a 70-year-old man has half the testosterone he had at the age of 20. Andropause is also correlated with the decline of other hormones: DHT (dihydrotestosterone), DHEA (dehydroepiandrosterone) and androstenedione, all androgenic hormones.
Symptoms
As it can be guessed, the andropausa triggers a series of rather problematic sexual alterations in the man, that they are concretized in anorgasmia, muscular atrophy, decrease of the libido, weakness, depression, erectile dysfunction, reduction of the ejaculate volume, anxious syndrome. But the andropause also involves a series of physical consequences: anemia, arrest of hair growth, thinning of the skin, increase in adipose deposits, gynecomastia, reduction of bone density.
Items such as smoking, diabetes, hypercholesterolemia and hypertension can exacerbate the symptoms listed above, especially those of a sexual nature.
Information on Andropause - Drugs for the Treatment of Andropause does not intend to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Andropausa - Andropause Treatment Drugs.
drugs
We have analyzed that some pathological factors can weigh heavily on the symptoms that characterize the andropause; for example, obesity, by itself, can reduce the physiological levels of testosterone in humans; consequently, the advanced age associated with the exaggerated increase in weight certainly does not help the maintenance of male sexual abilities. In such situations, to avoid this inconvenience, it is recommended to follow a low calorie diet and to practice constant physical exercise.
To understand: why does obesity negatively affect sexual activity?
An enzyme (aromatase) concentrated in the conversion of testosterone to estradiol is concentrated in the adipose tissue. The activity of this enzyme is then influenced by alcoholism and diabetes (type 2)
Analogous speech for hyperglycemia: we briefly recall that an erection is favored by the synthesis of nitric oxide, a powerful vasodilator that promotes male sexual excitement. Hyperglycemia, by predisposing atherosclerotic diseases, negatively affects erection control, as it drastically reduces the production of nitric oxide. According to this, it is well understood that the cure for hyperglycemia is useful not only for the control of symptoms related to diabetes, but also to avoid the worsening of symptoms related to andropause.
Estrogen replacement therapy (first-line treatment for menopausal symptoms in women) is not indicated in humans, since similar therapy may increase the risk of prostate cancer and aggravate the symptoms of andropause.
However, the administration of testosterone via the transdermal or intramuscular route can be very useful for treating the symptoms of andropause, since this hormone increases the lean mass to the detriment of the fat mass, and prevents anemia and bone fragility.
In the case of hormone replacement therapy for the prevention of andropause symptoms, it is recommended to undergo routine medical examinations, to check prostatic integrity and the values of testosterone, cholesterol and hemoglobin.
- Testosterone (eg. Testovis, Nebid, Androgel, Striant, Testogel, Androderm, Testoviron): testosterone is used in sexual dysfunctions related to hypogonadism (eg impotence, hypo-sexuality, decreased sexual desire, andropause in general), as well as for osteoporosis control. It is recommended to administer testosterone intramuscularly, to be repeated every 10-14 days: the drug is also available in the form of slow-release transdermal patches. The drug is available in an intramuscular injectable solution of 50-100 mg (of testosterone dissolved in sesame oil). The dosage should be carefully determined by the doctor, based on the severity of the patient's symptoms. Also available in the form of a 5 gram gel (with 50 mg testosterone), to be applied in the morning after cleansing and carefully drying the skin of the shoulders, arms and abdomen. Consult your doctor for more information.
Androgen derivatives : they block the activity of the aromatase enzyme, thus avoiding the transformation of testosterone into estradiol. Some androgen derivative drugs are used for the prevention of alopecia in the context of andropause.
- Mesterolone or 1 methyl-dihydrotestosterone (eg Proviron): it is a hormonal drug with an anabolic effect, indicated in therapy for the treatment of sexual dysfunctions caused by a deficiency of testosterone production, a distinctive element of andropause. Indicatively, the dosage suggests taking 50-100 mg of the drug in 2-3 daily doses. It is the duty of the physician to establish the dose most suitable for the patient and the duration of the therapy.
- Finasteride (ES. Prostide, Proscar, Propecia, Sitas, Finerid): this drug is authorized for the treatment of androgenetic alopecia in males, also in the context of andropause. The drug works by inhibiting the enzyme 5-alpha reductase (type 2), implicated in the miniaturization of the hair (which becomes thin and fragile). The recommended dose is 1 mg orally, to be taken once a day. It is important to emphasize that the therapeutic efficacy of the active ingredient is not immediate: the effect is generally observed 3-6 months after the first intake, and at the end of the therapy the problem reappears after 6-12 months. Recall that androgenetic alopecia is irreversible.
Selective modulators for androgen receptors : these innovative drugs, still under study, can preserve the benefits derived from estrogen therapy, minimizing the undesirable effects on prostate tissue.
Yohimbine : it is now known that the extract of Pausinystalia yohimbe can improve sexual performance and increase desire. Not to be forgotten, however, that the administration of a similar drug can generate significant repercussions in men at an advanced age. The active ingredient is an alkaloid molecule with an aphrodisiac activity. It is recommended to take an oral drug dose of 5.4 mg 3 times a day. You can reduce the dose to 2.7 mg three times a day or gradually increase it to 5.4 mg three times a day.
Drugs for the treatment of erectile dysfunction : indicated for the man who complains of symptoms of andropause, including erectile dysfunction.
For drugs and dosage. Consult the article on drugs for the treatment of erectile dysfunction
In addition to drugs, to control the symptoms related to andropause it is good to follow some preventive-behavioral rules:
- Treating diseases that could exacerbate the symptoms of andropause (alcoholism, diabetes, hypertension, hypercholesterolemia, obesity) → maintain good metabolic control
- Practice constant exercise
- Prevent osteoporosis
- Follow a balanced diet, low-calorie (when necessary), deprives excesses
