At the moment you feel tired, a little depressed, you realize that you have less and less libido and more and more erection problems. You’re probably saying to yourself: “It’s normal, I’m getting older, I’m sleeping less well and we’ve been together for a while…” Yes, maybe. But perhaps you are also going through andropause.
This term is commonly used to refer to the male version of menopause, but doctors prefer the term “age-related androgen deficiency” (Dala). Because if menopause, which affects all women, marks the exhaustion of their ovarian reserve, making them sterile, the same is not true for men. Because only a part of them will experience a gradual and mostly partial decline in testosterone production. Although it is difficult to measure its prevalence due to its taboo nature, andropause affects between 1 and 5% of men aged 40 to 50, and between 20 to 50% of those over 70.
What are the symptoms?
“Most of the men who consult me are concerned about their erectile dysfunction,” assures Doctor Vincent Hupertan, urologist, sexologist and creator of the Prostate Minute podcast. Not being able to obtain or maintain a satisfactory erection during sexual intercourse, accompanied by a drop in libido, pushes men to walk through the door of an office. But the symptoms of age-related androgen deficiency do not stop there: loss of energy, sleep problems, irritability, hot flashes, heavy sweating outside of any physical activity, weight gain, loss of muscle mass, bone fragility, muscle and joint pain, hair loss.
How to be diagnosed?
The problem with andropause is that its symptoms are very non-specific. It is common to feel tired, achy or depressed… Before leaning towards andropause, Stéphane Droupy, professor of urology at the University Hospital of Nîmes and the University of Montpellier, checks that his patient has at least one specific symptom (such as such as reduced libido, erectile dysfunction or osteoporosis) and two non-specific symptoms (fatigue, loss of muscle strength, mood disorder, insomnia, anemia, hair loss).
To ensure that it is indeed Dala, the urologist then orders a blood test to check for low testosterone levels. “The normal level for a man is 3 to 8 nanograms per milliliter,” continues the doctor. The diagnosis therefore falls when the number is less than 3.
What is the treatment?
“As we lack testosterone, we will simply put it back in,” explains Professor Droupy. To do this, there are two methods. The first consists of applying a gel to the shoulder area daily, but this process is not reimbursed. The second, reimbursed this time, takes the form of an intramuscular injection in the buttocks, to be carried out every three weeks, then every six weeks. “An intramuscular injection to be carried out every three months has also just been reimbursed,” adds the professor. However, this type of treatment should be avoided in people with a high risk of prostate cancer, as this cancer is hormone dependent.
Urologist and sexologist Vincent Hupertan also advises his patients to review their lifestyle. “Among men affected by this drop in testosterone, many suffer from type 2 diabetes, obesity or cardiovascular disease. Physical activity is therefore very recommended. » For the doctor, this is not a question of well-being, but a real subject of public health.