"A few years ago, I would have been standing in front of you in the jacket, which is no longer possible," says Karl-Heinz Steinmetz, Historian of Medicine and Director of the Vienna Institute for European Traditional Medicine (TEM), at the beginning of a conference Vienna End of May What the 55-year-old refers to is understood by looking at the title of the event: "The Changing Man".
hot flushes and sweating, mood swings, loss of sexual desire: these complaints – especially in this combination – are associated with menopause in women. What few people know: Even men enter change.
Analogous to menopause, the decline the testosterone level and associated symptoms often under the term "andropauseMany experts consider this inappropriate: "This suggests that there is a male equivalent to the menopausal years, which is wrong," says Shahrokh Shariat, director of the University Department of Urology at MedUni . Vienna, On the one hand, it is not a sudden, as in the woman, but a continuous decline in the production of hormones. "And second, hormonal changes do not affect fertility, as is the case in postmenopausal women."
The better known names are the abbreviations LOH (late onset hypogonadism) or ADAM (androgen deficiency in the elderly male), in German PADAM (partial deficit in androgen of the elderly male). Disagreement is the science of the number of men affected. Although studies show that men over 40 lose about 2% of testosterone per year, there are only a few studies of men in transition.
In the 2016 European Male Aging Study (EMAS), the researchers summarized that about three percent of all men suffered from LOH syndrome. Other studies examining a broader picture show that 5 to 7% of those under 50 and about 30% of men over 50 are affected.
More belly fat, less desire
The fact is that the sinking the testosterone level can cause unpleasant symptoms. These range from those already mentioned loss of libido and erectile dysfunction related to abdominal fat growth, decreased muscle strength and bone density, and fatigue caused by nervousness, difficulty concentrating, and depressed mood. "All these complaints can be weak the testosterone level Shariat says, "If the latter is diagnosed by a blood test, as a doctor, you weigh the hormone."
Until the prescription of a testosterone replacement therapy, many factors need to be clarified. The concentration of testosterone in the blood of man is not always the same: the value varies between a maximum in the morning and a minimum in the afternoon. Values between 12 and 30 nanomoles per liter of blood serum are considered normal values. If the the testosterone level falls well below and complaints occur (and only then), patients are treated with drugs.
The hormone is administered by means of a syringe, a gel applied daily, a scrotal patch (plaster to stick on the scrotum) or implants. "Before this happens, it is necessary to discuss the advantages and disadvantages of interviewing the patient.Testosterone levels should be monitored continuously during treatment," says Shariat.