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Researchers unzip symptoms of the male menopause

Scientists have for the first time identified the symptoms associated with what has been termed late-onset hypogonadism or ‘male menopause’ caused by a reduction in testosterone production in ageing men.

But the researchers say that unlike the female menopause, which affects all women, the male menopause is relatively rare, affecting only 2% of elderly men, and is often linked to poor general health and obesity.

The findings, published in the New England Journal of Medicine, should provide new guidance to physicians prescribing male testosterone therapy, a practice that has increased by 400% in the United States, though not elsewhere, since 1999.

The University of Manchester researchers, working with colleagues at Imperial College London, UCL (University College London) and other European partners, measured the testosterone levels of 3,369 men between the ages of 40 and 79 years from eight European centres and asked details about their sexual, physical and psychological health.

The team found that only nine of the 32 candidate symptoms were actually associated with low testosterone levels, the most important being the three sexual symptoms – decreased frequency of morning erection, decreased frequency of sexual thoughts (sex drive), and erectile dysfunction.

The study concluded that the presence of all three sexual symptoms, together with low testosterone levels, was required to establish a diagnosis of late-onset hypogonadism, although other non-sexual symptoms may also be present.

These other symptoms included three physical symptoms – an inability to engage in vigorous activity, such as running or lifting heavy objects, an inability to walk more than 1km, and an inability to bend, kneel or stoop – and three psychological symptoms – loss of energy, sadness, and fatigue. However, these non-sexual symptoms were only weakly related to low testosterone.

Additional symptoms often said to be associated with the male menopause but which the study was able to discount as not being testosterone related included changes in sleeping pattern, poor concentration, feeling worthless, nervousness or anxiety and difficulty getting up from a chair.

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