The once questionable notion of "male menopause" is gaining credibility among scientists and physicians as evidence mounts that hormonal changes can significantly affect the health of men as they age.
A steady accumulation of research over the past five years has linked men's natural decline in testosterone and other hormones to osteoporosis, depression, an increase in body fat, muscular degeneration, decreased libido, fatigue and changes in mental acuity.
"I think it's very significant and very important," said Adrian Dobs, an endocrinologist at the Johns Hopkins School of Medicine who studies male hormonal change. "There have been estimates that as many as 15 [percent] to 20 percent of men over 65 suffer from low testosterone levels. It's high, but it's not everyone. It's important to note that it won't take place in all men."
Recent research has been convincing enough that in March, the Journal of Urology published an appeal to physicians to recognize hormone-related changes in some men as a distinct clinical condition.
The journal reported that emotional and physical changes associated with hormonal declines in men need to be not only monitored, but also given more serious attention from a largely skeptical medical community.
"There's more data coming out all the time that the aging male is really more affected by low testosterone levels than we ever really thought," said one of the authors, Dr. Culley Carson III of the University of North Carolina. "These are general health issues, not just sexual problems."
A lack of understanding of men's hormonal changes - known as "andropause" when testosterone levels become deficient - is thought to be common among American physicians.
The problem is exacerbated by irresponsible claims by overzealous advocates about testosterone's ability to boost self-confidence, drive aggression and even make men more successful in business.
Many urologists, who treat hormone deficiencies, are skeptical and regard "male menopause" as a laughable notion.
"It's a highly under-diagnosed problem," said Phillip Ginsberg, urology department chairman at Albert Einstein Medical Center in Philadelphia. "Doctors know a lot about how to treat female hormonal changes but very few know how to recognize and treat men.
`This is embarrassing'
"I recently did grand rounds [teaching by case study] about it for the department of medicine here, and you could hear the urologists mumbling under their breaths, `This is embarrassing.' The general population is more aware than a lot of doctors."
