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16 December 2002
Is Male Menopause A Myth?
by George Atkinson

Is male menopause a myth? Perhaps not, says Laurence M. Demers, Ph.D., distinguished professor of pathology and medicine and director of clinical chemistry and the automated testing laboratory at the M.S. Hershey Medical Center of Penn State University. According to Dr. Demers, there does appear to be a physiological basis - as there is in women - for what is known as andropause, or male menopause.

Male menopause is a phenomenon many women have claimed to observe over the last few decades. But shifting from social observation to scientific examination, clinical chemists, scientists, and clinical pathologists are learning more about the relatively recent concept of andropause, which can be identified through male testosterone.

The issue of male testosterone levels has received increased attention in recent years because of the growing use of Viagra.

"Why are so many men on Viagra?" Dr. Demers asks. "Are there large numbers of men with libido problems?"

Researchers are theorizing that just as females experience menopause due to decreasing levels of estrogen, males may experience their own version - andropause - with decreasing levels of testosterone. Symptoms that may bring men into their doctor's office to have their testosterone checked include male infertility and a lessening of their sex drive.

Most clinicians will first test the total testosterone level. Normal levels fall between 250-800 ng/dl. A reading below 250 indicates low testosterone levels. For someone with a low testosterone level, further examination is warranted. If further tests, which determine the levels of free testosterone and albumin-bound testosterone, are also low, the physician will try to identify the cause. Low testosterone levels may be the result of either testicular or pituitary dysfunction.

Dr. Demers and his colleagues have found evidence that testosterone levels and androgen precursor steroids may vary among different ethnic populations.

A study of Portuguese, American, and Asian men, for example, revealed that the average testosterone level in the Portuguese subjects was ~ 500, in Americans, ~ 450, and in the Asian population, ~ 400.

Larger differences were observed with the androgen precursor steroids like DHEA. Asian men generally have less facial and body hair than Americans, who generally have less than the Portuguese.

There is also a lower incidence of prostate cancer among Asian men, leading researchers to theorize that testosterone may be a "driver" for prostate cancer, much as estrogen may be a "driver" for breast cancer.

That theory is further supported by the evidence that African American men have higher testosterone levels, and higher rates of prostate cancer as well.

"This is all preliminary evidence however," says Dr. Demers, "and needs to be rigorously confirmed scientifically."

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