Male Andropause

PADAM is an abbreviation for Partial Androgen Deficiency in Ageing Males, another term for Andropause.

There are six easily recognisable symptoms of male andropause.

1. Low sex drive and reduced erectile quality, particularly nocturnal erections.
2. Mood changes, irritability, fatigue and depression.
3. Decrease in lean body mass, with associated diminution in muscle volume and strength.
4. Decrease in body hair.
5. Decrease in bone mineral density resulting in osteopenia and osteoporosis. One in 12 men over the age of 60years may suffer from this.
6. Increase in visceral fat.

Other symptoms may include an increase in sweating and hot flushes, aches and pains in joints, difficulties in gaining and sustaining erections, decreased sensitivity of the penis, and diminished volume of ejaculate.

Many of these symptoms may also have other causes, a lifestyle history, including exercise and diet, sleeping pattern, relationship problems and stress, need to be investigated.

Mean serum testosterone levels decline after the age of 50 years at approximately 1%/year, biochemical hypogonadism is found in 7% of men over 60 years, but men with low total and or free testosterone may suffer and need a trial of Testosterone replacement therapy over a 3 month period.

At the 9th World Congress of ISSAM in Prague October 2015. Professor H. Jones stated that low free testosterone in diabetic patients is important in Erectile Dysfunction.

“Diet, exercise and Testosterone replacement only benefits 1-2 % of diabetic patients. However Testosterone improves insulin transport, glycolysis and mitochondrial function for glucose metabolism, and has a useful function against atherosclerosis.”

Another important quote from Professor Claude Schulman of Brussels University.
“The evidence does not support an increased risk of prostate cancer with testosterone replacement therapy.”

Men with low total and free testosterone levels are at an increased risk of prostate cancer. (Ref. Statin et al. Int. Cancer 108 418-424, 2004.)