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Saturday, 25 March, 2000, 22:51 GMT
Hope for 'male menopause'

Is there such a thing as the male menopause?
Men entering middle-age suffer physical symptoms that could be treated with similar techniques used to tackle the female menopause, it has been argued in the British Medical Journal.

A group of doctors from a private men's health clinic say teststerone levels in men reduce from middle-age - and that hormone therapies could combat the resulting symptoms.

The existence, or otherwise, of the 'male menopause', has long split the medical profession.

Many men complain that on entering middle-age, they feel discontented, depressed and tired, or lose their sex drive.

The doctors from the WellMan Clinic in London say the symptoms are real and treatable.

But a hormone expert from a top London hospital argued that giving men doses of hormones was not the best solution.

Hot flushes

The menopause in women normally happens around the age of 50, when the ovaries, which produce reproductive hormones, shut down either suddenly or gradually.

It is associated with symptoms like hot flushes - in which the body has trouble regulating its own temperature - decreased libido, vaginal dryness and fatigue.

Women are also at higher risk of heart disease and brittle bone disease after the menopause.

Many women take hormone replacement therapy to relieve these symptoms.

Testosterone levels

Dr Duncan Gould, a consultant at the WellMan Clinic, said that while men did not suffer the same sudden drop in hormone levels as women, the amount of useable testosterone in the body fell away steadily from early middle-age.

Many of the symptoms of the 'mid-life crisis' - depression, anger, irritability and general lack of contentment - can be linked to lower testosterone levels, he said.

"Vasomotor disturbance [hot flushes] and night sweats occasionally occur, their association with testosterone deficiency and relief by testosterone replacement being noted as far back as the 1930s," he said.

He also pointed out that dropping testosterone levels could - just like falling sex hormone levels in women - reduce the bone density of the spine and hip, increasing the risk of fractures.

"Owing to the similarity between most of the symptoms in men and women the term menopause gained popularity and has unfortunately stuck," he said.

Viagra answer

However, Howard Jacobs, professor of reproductive endocrinology at the Royal Free and University College School of Medicine, said that the merits of hormone replacement for men were far from proven.

He said: "It is easy to see the attraction of an endocrine explanation because it raises the possibility of hormone treatment. There is, I am afraid, a long way to go."

He said that testosterone treatment given to elderly men had failed to increase bone mineral density.

And he said that for men losing the ability to achieve erection, it would be better to give them Viagra than a sex hormone like testosterone.

"I do not find the analogy of the female menopause helpful in understanding or trying to manage the problems of ageing in men."

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