Some men go through 'the change', too
By Eveline Gan, TODAY | Posted: 10 November 2009 0836 hrs

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SINGAPORE : Grumpiness, irritability, lethargy and loss of libido - by all accounts, these seemed like the bothersome symptoms of menopause, except that the sufferer was not a woman.

Three years ago, Bernard (not his real name) suffered from the ill effects of falling testosterone levels (or andropause).

"Something was wrong with me, but I couldn't identify the problem. I took more vitamins to energise myself but that did not work," said Bernard, who is in his 50s.

Because he felt so weak all the time, his work and sexual relationship with his wife was badly affected.

"When a man's personal life is in a mess, he will be affected emotionally and mentally, too. I was miserable," he said.

Bernard is not alone.

Results from a local health screening of 1,000 men show that as many as one in four men aged 40 and above are testosterone-deficient.

The screening programme is part of an initiative by the Society for Men's Health Singapore.

Somewhat similar to menopause, andropause occurs as a result of falling hormone levels in the body, said Dr Tan Kok Kuan, chief medical officer of The Men's Clinic.

However, he added, unlike in older women, andropause does not occur automatically when men reach a certain age. In fact, they can still remain fertile even with the condition.

"Although men do not experience the mood swings often associated with menopause, they will experience psychological symptoms such as a depressed mood, loss of concentration and increased anxiety. They sometimes describe the feeling as being 'burnt out' or having 'passed their peak'," said Dr Tan.

"These mood changes and deterioration in sexual function can also have an impact on the patient's spouse as well," added Dr Ng Chee Kwan, a consultant of the department of urology at Tan Tock Seng Hospital.


Mind and body affected

Health-wise, being testosterone-deficient also puts men at a higher risk of certain medical conditions.

According to Dr Ng, andropause sufferers such as Bernard - who also has Type 2 diabetes and hypertension - are more prone to developing osteoporosis and loss of muscle mass. Their cholesterol levels may go up, placing them at a higher risk of heart disease.

The local health screening results found that among the testosterone-deficient men, 41 per cent had high cholesterol, 43 per cent had hypertension, 26 per cent had diabetes and 93 per cent had sexual health problems.

On the other hand, Dr Tan said that men who are obese or suffer from chronic diseases, such as diabetes, are at a higher risk of developing andropause.

Thankfully, the condition is easily treatable with testosterone supplementation, said Dr Ng.

"This can be in the form of a daily dose of oral medication or a testosterone injection every three months," said Dr Ng, adding that with treatment, the overall quality of life will improve considerably for patients.

However, Dr Tan stressed the importance of ensuring that the symptoms are not caused by other medical conditions.


Happy again

By his second round of testosterone replacement therapy, Bernard said that he was "a happier person".

"After the therapy, I feel active again both in my personal and work life. My relationship with my wife is also much better now," he said.

Dr Teoh Seng Hin, a consultant gynaecologist at SH Teoh Clinic and Surgery for Women with an interest in men's health, said at the launch of the health screening results last month: "We need to get more men to sit up and take charge by emphasising that testosterone is more than just about sex - it is the vital link to healthy ageing."



Mind your testosterone levels

Men aged 40 and above who would like more information on safer sex practices, erectile dysfunction and testosterone deficiency syndrome can call HealthLine at 1800-223-1313 during office hours. Those who wish to self-assess their risk of testosterone deficiency syndrome can log on to www.menshealth.org.sg.

- TODAY/il