The Tribune

By DR GREGGORY PINTO

Andropause, the male menopause, is a real health condition that thousands of Bahamian men, like their counterparts worldwide, often suffer unknowingly. The symptoms such as low energy levels, fatigue, memory problems, cardiac and circulatory issues, lack of stamina, heat intolerance, loss of muscle mass, osteoporosis, depression, irritability, and most importantly for most Bahamian men, erectile dysfunction. These symptoms are often dismissed as an inevitable part of aging.

Andropause affects an estimated 10 million American men and those numbers can be extrapolated to our Bahamian society.

There is usually a precipitous fall in testosterone in men from mid-forties and older. A sedentary lifestyle with decreased activity, weight gain, increased stress levels and certain medications as well as intake of alcohol and cigarettes can hasten the fall in testosterone levels.

Hormonal imbalances involving thyroid imbalance, high oestrogen levels, high or low cortisol, high DHT dihydrotestosterone, low DHEA dehydroepiandrosterone and the mentioned low testosterone levels can also contribute to middle-aged men feeling like a shell of their former self.

Older men often experience an extreme heat intolerance and even hot flashes like the middle-aged women, and they may sweat profusely in a cold air-conditioned room.

Growing old is a blessing and inevitable but men can age gracefully without all the ill health effects of hormone imbalances and gradual fall in testosterone.

Bahamian men require PSA (prostate specific antigen) blood testing as part of their annual physicals starting at age 40 years old as men of African ancestry often develop a more aggressive form of prostate cancer and at an earlier age. Checking testosterone levels should also become the norm once a man is in his mid- to late forties.

Late onset hypogonadism, low testosterone is part of the larger metabolic syndrome experienced by a large number of middle-aged men that involves potential onset of or more difficult to control diabetes, hypertension, dyslipidemia, and cardiac and circulatory health issues.

Andropause management should include good nutrition, proper weight management, regular exercise, stopping smoking and reduces regular alcohol intake. Testosterone has an important role in protecting cardiac and circulatory function, brain cognition, and bone density as well as the all important erectile function.

Hormone testosterone replacement in multiple international long-term studies has been shown to be safe and with immense health benefits that will increase a man's longevity and quality of life.

A well recognised medical study from 2016 involving 755 middle-aged men with severe coronary artery disease found that those who received testosterone therapy had much better outcomes than those who did not receive testosterone therapy, who were almost 80 per cent more likely to experience an adverse medical event.

Thousands of middle-aged Bahamian men often mask the erectile symptoms of low testosterone by self-prescribing themselves often unregulated sexual stimulants.

Testosterone supplementation may take the form of a once monthly or twice a month injection, a transdermal patch or the application of a gel.

Bahamian men, you now know that male menopause is a real heath entity that could potentially have devastating health complications and may significantly reduce not only the quality of one's life but the longevity. Live a healthier and longer life and regain your sexual libido and stamina and erections.

• Dr Greggory Pinto is a Bahamian urologist who has trained in South Africa, Germany and France. He is a member of the European Association of Urologists. Dr Pinto can be reached at Urology Care Bahamas at the Surgical Suite, Centreville Medical Centre, Collins Avenue and Sixth Terrace. Call 326-1929, e-mail welcome@urologycarebahamas.com, or visit urologycarebahamas.com.