AUSTRALIA: Thousands Suffer From Grumpy Male Syndrome

Well Men Centre in Perth sees thousands of men with the grumpy old man syndrome ... to gather the evidence base to support testosterone treatment for aged-related decline. Is it a medical condition or just an excuse for bad behaviour? Tracey Roberts looks at male menopause. PERTH, Western Australia (The West Australian), July 27, 2006: It would appear that when some men reach a certain age — around 50 — they no longer take on the world with the vigour displayed in their prime. The muscles ache, it’s harder to get out of bed, their sex life suffers dramatically and poor sexual performance increases irritability. Enthusiasm wanes, they don’t hit the tennis ball as hard, weight starts to build around the gut and generally they just don’t feel well. Ultra Health Clinic naturopath Hilary Lane said these symptoms might signal the onset of andropause or male menopause. “Andropause is the result of low hormone levels, particularly testosterone and DHEA, in men as they age,” she said. According to Andrology Australia, men have a slow decline in testosterone that may start to occur at a rate of one to 2 per cent in their 30s. While it is often referred to as male menopause, this term is misleading because, unlike female menopause, there is no absolute defining moment like the end of menses to herald the change of life and it occurs to varying degrees in men and often not at all. Anti-ageing medical practitioner Joe Kosterich said the cause of the grumps was never as simple as one factor such as low testosterone levels. “Less exercise, excessive weight, soreness of muscles and strain on the heart all interrelate, resulting in less energy,” he said. “With men, if they tend to get more fat cells around the middle, they will tend to produce more oestrogen relative to a decline in testosterone.” Ms Lane said a drop in testosterone could increase the chances of heart attack, stroke and diabetes. Hormone replacement for men is available, although what constitutes testosterone levels low enough to warrant treatment — if at all — is debated in the health profession. Adrian Zentnor, medical director of the Well Men Centre in Perth, sees thousands of men with the grumpy old man syndrome and 90 per cent had what he considered to be low levels of testosterone. Most improved on testosterone replacement therapy. Carolyn Allan, endocrinologist and medical adviser to Andrology Australia, said when applying clinical guidelines established by the Endocrine Society of Australia, only 10 per cent of men over 60 had low levels. “It has been difficult to gather the evidence base to support testosterone treatment for aged-related decline,” Dr Allan said. “It has shown to increase muscle and bone density but there is no strong evidence for consistent improvement or whether it increases wellbeing. “There are also concerns that we don’t know the effect on the prostate in particular and cardiovascular disease.” Dr Allan conceded that despite this, clinicians were widely using testosterone replacement and even the men she saw in practice anecdotally reported its benefits. Ms Lane said natural hormone replacement might work well but cautioned that only small doses should be used — equivalent to what the body would produce. “The safest way to improve your hormones naturally is to have tests before taking them and be monitored during treatment,” she said. Dr Kosterich said testosterone was not the fountain of youth and shouldn’t be seen as such. “The solution is likely to involve much more than hormone levels and include nutrition, vitamins and nutrients like zinc, vitamin B12 and folic acid and resistance-type training to build muscle mass,” he said. The message that is consistent from all health professionals is that men experiencing the symptoms of andropause should get along to their doctor for a check-up. “What is important is excluding disease and then looking at what can be done to make you feel better, and that may be getting help from a doctor or dietitian, naturopath, life coach or personal trainer,” Dr Kosterich said. Copyright West Australian Newspapers Pty Ltd 2006