Causes, symptoms, and self-assessment of male andropause syndrome

Are you familiar with male menopause syndrome?

Many people believe that menopause is a woman's prerogative. In fact, men also experience menopause. Because both men and women, as they age, go through a period from peak reproductive years to the post-reproductive years (the stage of loss of reproductive capacity). In this sense, both men and women must pass through menopause before entering old age.

Male menopause refers to a specific period in a man's life from middle age to old age. It is a transitional period based on abrupt changes in hormone levels, biochemical environment, and psychological state from their peak to decline. If this process is too drastic, it can adversely affect the function of multiple organ systems and reduce quality of life, manifesting as certain psychosomatic symptoms and/or signs. It may be accompanied by or without decreased serum testosterone levels, a condition known as male menopausal syndrome. The term "male menopause" was first coined by Istanbul psychologist Heller in 1939, but it was not accepted by the medical community until 1994 when the Austrian Urological Society proposed "partial androgen deficiency syndrome in middle-aged and elderly men." Currently, the medical community also uses various terms to describe male menopause, including "male menopause," "androgen deficiency," and "late-onset hypogonadism."

With the increasing prominence of my country's aging population, male menopause has attracted much attention. Generally, most men begin menopause between the ages of 40 and 55, but some begin as early as 35 or as late as 65, or even 70. However, not all men experience clinical symptoms after entering menopause. Statistics show that 30% to 40% of middle-aged and elderly men may experience varying degrees of menopausal symptoms and signs. In other words, this transitional period can be a normal aging process or a disease process accompanied by clinical symptoms. If the changes are relatively mild, no clinical abnormalities may be observed.

What causes male menopause syndrome?

It is now believed that androgen deficiency is the main cause of male menopause syndrome. However, it must be emphasized that the decline in male sex hormones is gradual and varies greatly from person to person. Furthermore, a decline in sex hormones is not the only cause of male menopause symptoms.

Specifically, male menopause syndrome is related to a variety of factors. In addition to age, the following factors also play a role: high work and life stress; chronic diseases such as diabetes, depression, and cardiovascular disease; unhealthy lifestyle habits such as smoking and excessive alcohol consumption; poor living environment; lack of physical exercise; and abdominal obesity.

What are the symptoms of male menopause syndrome?

Due to physiological differences between men and women, especially the different patterns of sex hormone decline, the symptoms of male menopause differ from those of female menopausal syndrome. Male menopause symptoms are complex, diverse, and lack specificity. So, what symptoms fall under the category of male menopause syndrome? They mainly manifest in the following aspects.

Physiological symptoms include decreased physical strength and energy, easy fatigue, loss of appetite, constipation or diarrhea, bone and joint pain, decreased muscle mass and strength, frequent lower back pain and leg weakness, loss of pubic hair, and abdominal obesity.

Psychological symptoms: poor concentration, memory loss, irritability, anger, suspicion, distrust, or emotional detachment, pessimism, and loss of enthusiasm for life.

Neurological symptoms may include shortness of breath, localized numbness, tingling, cold extremities, pain in various locations, or a crawling sensation on the skin. Autonomic nervous system dysfunction primarily manifests as cardiovascular symptoms such as palpitations, discomfort in the precordial region, fluctuating blood pressure, dizziness, tinnitus, seeing black spots, hot flashes, and intermittent sweating; neurasthenia symptoms may also include insomnia, difficulty sleeping, vivid dreams, easy startling, forgetfulness, and slow reaction time.

Decreased sexual function: decreased libido, reduced sexual activity, erectile dysfunction, decreased orgasm and libido, weak ejaculation and reduced semen volume, etc.

It should be noted that there is currently no unified standard for diagnosing "male menopause syndrome." Diagnostic methods must be strictly adhered to to avoid over-diagnosing or under-diagnosing. Both domestic and international diagnostic methods for "male menopause syndrome" combine laboratory testing, relevant symptom scoring, and diagnostic treatment, with the effectiveness of diagnostic treatment serving as the final diagnostic criterion, and relying on clinical practice to verify the diagnosis.

Do you have male menopause syndrome?

Researchers have designed numerous scales to assess male andropausal syndrome, such as the Aging Symptom Rating Scale (AMS), the Androgen Deficiency Survey for Middle-Aged and Older Men (ADAM), the Massachusetts Male Aging Study Questionnaire (MMAS), and the Screening Symptoms of Late-Onset Testicular Dysfunction (SILOH). You can answer the following questions to assess whether you have male andropausal syndrome.

Male Aging Symptoms Rating Scale (AMS)

Overall health decline (general health status, subjective feelings);

Joint pain and muscle pain (lower back pain, joint pain, limb pain).

Excessive sweating (sudden onset of sweating, hot flashes);

Sleep disorders (difficulty falling asleep, early awakening, poor sleep quality, lack of sleepiness);

I often feel tired and sleepy;

Temperamental (easily agitated and easily angered by trivial matters);

Nervousness (tense, anxious);

Fear;

Fatigue/reduced activity (decreased physical fitness, reduced activity, lack of interest in leisure activities, feeling that one must force oneself to participate in some activities);

Decreased muscle strength (feeling weak);

Depression (feeling down, pessimistic, feeling that nothing is meaningful, losing motivation to live, and being on the verge of crying);

I feel like I've passed the peak of my life;

Feeling utterly exhausted, as if the end is near;

Beard growth has decreased;

Decreased sexual function and reduced frequency of sexual activity;

Reduced frequency of morning erections;

Decreased libido and sexual satisfaction.

Evaluation method: Each symptom is scored as follows: extremely severe (5 points); severe (4 points); moderate (3 points); mild (2 points); none (1 point).

Results: A total score ≥50 indicates severe symptoms, 37-49 indicates moderate symptoms, 27-36 indicates mild symptoms, and ≤26 indicates no symptoms.