KEY POINTS:
Men, the next time you feel depressed or anxious and feel the effects of low libido, you may be suffering from male menopause.
Menopause is mostly associated with women - but they may not be the only ones suffering the effects of changing hormones.
Some doctors and endocrinologists swear male menopause exists; others dismiss it as a myth.
Women go through menopause around the age of 50, and within the next five years their oestrogen levels drop rapidly.
With lower levels of oestrogen, women experience dramatic physical and psychological changes and the menstrual cycles cease. And women know what the changes mean.
Like women, men experience a drop in the levels of sex hormones as they grow older.
But the changes for them are quite different.
Doctors now say that their male patients display the same symptoms that women experience in the transition to menopause and in menopause itself.
Until recently, the subject of male menopause was confusing and to some degree controversial.
While women go through middle-aged crises and menopause-related symptoms, men go about cultivating the myth of the "ageless male" and "boasting virility all the way to the grave".
Male menopause came to the fore after the the drug Viagra, to combat male impotence and erectile dysfunction, went on sale in 1998.
Before that, health authorities and media paid little attention to the prevalence or seriousness of male menopause as a medical condition.
But even today there is debate as to whether it exists, as drinking excessive alcohol, lack of exercise, smoking and hormone deficiencies, among other things, could lead to the same affliction.
Auckland urologist Robin Smart says male menopause is a reality for some men but it is definitely different from female menopause.
"Some men do get low male hormone levels of testosterone as complications of getting older creep in.
"It tends to be a slower, much more drawn out process - gradual - than for women, which tends to be a sudden and specific event, and they can identify when it happens."
For men, the age of onset also varied considerably, Mr Smart said.
Male menopause is often described as a drop in male hormone levels after middle age, leading to depression, anxiety and low libido.
It also is used to describe mid-life crisis that happens to some men during late 30s and early 40s.
Opponents dismiss it as a myth, saying that because men's testosterone levels fall gradually, their bodies should adapt to the lower levels.
Testosterone is a hormone that helps maintain sex drive, sperm production, pubic and body hair, muscle and bone.
Women lose fertility when they reach menopause; men do not.
Mr Smart said symptoms associated with male menopause were in some ways similar to women's - lethargy and weakness, loss of interest in sex and lack of performance in that area.
Other consequences of low testosterone would be depression, loss of sense of humour, lacking a positive attitude to problem solving, muscle weakness, and some loss of memory.
"Most important is the lack of interest in sex. That is what brings the men to seek help."
Male menopause did not happen to all men, Mr Smart said.
Affected men could readily be identified by running blood tests and checking on the male hormones and associated hormone levels, if there was a problem.
A small percentage of New Zealand men had low testosterone, he said.
"About 15 to 20 per cent of men over the age of 50 have sexual problems, but this is almost always due to a physical fault of some sort.
"Of this group, only about a 10th would suffer from low testosterone - overall probably about 2 or 3 per cent of the male population."
Endocrinologist and associate University of Auckland professor John Conaglen would put the figure even lower.
He believes male menopause is a myth: "Male menopause was created to marry up with the change that occurs in the female menopause.
"There are a lot of complex issues around it and it has been given a number of terms - andropause, male ageing, mid-life crisis."
Dr Conaglen said there was no evidence that male menopause existed, and no decent study in scientific literature to suggest there was such a condition. "There is no equivalent in men of the female menopause.
"However, there is good evidence to suggest that testosterone levels in males decline with age - very slowly and very gradually, nothing like the rapid decline that you see in the females."
Dr Conaglen said most of the information available on the internet - suggesting that all ageing problems could be fixed with testosterone - was treated as gospel truth.
Giving testosterone to ageing males might increase the risk of other diseases, particularly prostate cancer.
Experts do agree there is a condition caused by hormone deficiencies, excessive alcohol consumption, smoking, hypertension, prescription and non-prescription medications, poor diet, lack of exercise, poor circulation and psychological problems.
What they cannot agree on is whether it should be termed "male menopause" or simply a mid-life crisis, male ageing or andropause, brought about by decreasing levels of testosterone.
If a healthy male is capable of producing sperm well into his 80s or even longer, perhaps he should not fret about his sagging virility in his "menopausal years".
A dose of testosterone may help perk him up ... or perhaps a flash red sports car, a beautiful blonde and a six-pack.
- NZPA
