Male Menopause & Chronic Fatigue Syndrome
By John W. Addington •
January 2, 2002
It might come as shock to some but men can suffer from a form of menopause similar to what women endure. In fact this malady, sometimes called male menopause, shares a number of Chronic Fatigue Syndrome (CFS) symptoms. Could it be then that some men thought to have CFS are actually suffering from this treatable hormone deficiency instead? While the answer is not so straightforward, often those treated for male menopause find relief from at least some of their "CFS" symptoms.
What is Male Menopause?
Male menopause has been studied for decades although it often goes by other names. Some experts feel the name "male menopause" is inappropriate since this condition varies somewhat from the better-known condition women endure. The outcome for women going through menopause is infertility, while men may still be capable of reproduction in their 70s.
Dr. Todd Nippoldt, a hormone doctor at Mayo Clinic, explains another difference. "Female hormone production plummets over a relatively short time frame. In men, there's a gradual decline in the production of male hormones." Thus the decline in production of sex hormones in most men is usually slow and progressive.
Nevertheless there is considerable variation among men in that tapering process with a resultant variation in symptom severity. Dr. Robert Tan, a Geriatric specialist, has extensively studied and written about male menopause. According to his research, Dr. Tan informs that "not all men undergo male menopause to the same degree or extent." Echoing this comment a Geriatric Nursing article on male menopause states, "in men, the experience of hormonal decline varies greatly."
Which hormones are involved in this age-associated decline? Primarily testosterone and DHEA. The testes chiefly produce testosterone with a portion the body's supply also coming from the adrenals. This hormone is responsible for stimulating male sexual characteristics, libido, and the development of male sex organs and the production of sperm. Testosterone also aids in protein synthesis, immune function, the growth and muscular development of men and supports skin and bones.
DHEA mainly comes from the adrenal glands and this hormone in turn generates the production of testosterone. DHEA has anti-stress and immune strengthening properties along with the ability to improve sleep, mood and energy levels. Because of its contribution to vigor and vitality DHEA is sometimes called the fountain of youth.
Other hormones that decline with age and contribute to the symptoms of male menopause are growth hormone and melatonin. Reduced growth hormone leads to diminished muscle and bone strength as well as low energy levels. Reduced melatonin disturbs proper sleeping cycles needed for normal growth hormone production.
Hypogonadism is a condition similar to male menopause. Hypogonadism simply means a decrease or altogether missing production of hormones produced by the testes. Unlike male menopause, hypogonadism does not necessarily relate to the aging process and may cause infertility. Otherwise, many symptoms between the disorders are the same. Hypogonadism can result from a disorder of the testes themselves or dysfunction of other glands which control the testes. Tumors, trauma, radiation, genetics, surgery, drug usage or nutritional deficiency may be the initial cause.
What Are the Symptoms?
Dr. Anton Dotson from the Cenegenics Medical Institute in Los Vegas lists some of the symptoms of male menopause as
· Decline in muscle mass and strength
· Increase in body fat mass
· Decrease of bone mass
· Decline in sex drive and sexual difficulties
· Decreased sense of overall well-being, perception of energy level, and vigor
· Decline in stamina and exertional performance
· Decline in cognitive skills, concentration and memory
· Coronary artery disease and higher cholesterol levels
Dr. Alan Mintz, from the same medical institute, explains that symptoms can "include loss of strength (if left untreated, this can lead to gradual muscle atrophy); loss of energy (getting tired early in the evening, falling asleep in front of the TV); stiffness and aching of muscles and joints." Most experts agree that chronic fatigue is a primary symptom of having diminished sex hormone levels.
Hormone balance whether in women or men, contributes to emotional stability. That explains why those undergoing male menopause may experience mood swings, irritability, depression, nervousness, and anxiety. Sleeping patterns can also be altered contributing to less-restful sleep.
How may male menopause and CFS or FMS be related?
Doctors who treat patients with CFS or FMS have found abnormal levels of sex hormones in both their male and female patients. Dr. Jacob Teitelbaum is the director of the Annapolis Research Center for Effective FMS/CFS Therapies. He states that "low testosterone is a major problem in 70 percent of my male patients with CFIDS/FM."
Similarly, studies have shown the hormone DHEA, which promotes the production of testosterone and other sex hormones, to be low in CFS patients. Dr. David Brownstein has written several books on natural hormone therapy. He has 'observed consistently low DHEA levels in most individuals with fibromyalgia and chronic fatigue syndrome.' Likewise studies have shown that growth hormone which is reduced in male menopause is also diminished in those with CFS.
That CFS and male menopause may be related seems logical based upon the research establishing abnormally low levels of the hormone cortisol in CFS patients. The hormone chain reactions that lead to proper levels of cortisol are intertwined with the hormone chain reactions that balances the testes production of hormones. Alterations in one chain can easily effect the other chain. So perhaps in some patients with CFS while the original cause of their problems may be alterations in the cortisol hormone chain, abnormally low levels of sex hormones result that actually bring on the symptoms.
Is There Treatment for Low Sex Hormones?
There is good news if you suffer from low levels of sex hormones. Hormone replacement therapy has been effective in bringing relief. The British Medical Journal recently discussed sex hormone replacement therapies in an article on male menopause. It noted that this therapy was valuable in relieving many of the symptoms of diminished sex hormone levels. The article spoke of one study on testosterone replacement therapy that "showed significant improvements in energy levels and tiredness."
The Journal of Urology also recently carried an article on male menopause. This article provided a comprehensive coverage of testosterone replacement therapy. Testosterone can be administered via skin patches, creams, injections, and pills. Dermal patches best approximate the natural cycles of testosterone release. Because orally taken pills may be absorbed and dissipated too rapidly, erratic mood swings can result. As noted in The Journal of Urology injections are the "most cost-effective" method but can also have "noticeable ups and downs" in their effects.
For his male patients with reduced testosterone, Dr. Teitlebaum recommends injections of 100-125 mg testosterone every 7-10 days coupled with daily application of testosterone cream after 8 weeks. He prefers this to testosterone patches or tablets. Explaining another approach, Dr. Teitlebaum says "I'm beginning to suspect that avoiding other possible side effects by using the hormone cream twice daily (instead of getting high and low levels by taking the shot every week or two) is better."
Caution when receiving this kind of care is essential. Replacing diminished sex hormones is a form of steroid treatment and can have unwanted side effects. Thus when undergoing sex hormone replacement therapy it is always best to be under the care of an experienced physician. Using natural, as opposed to synthetic, hormones can greatly decrease the risks involved.
One natural, over-the-counter product that may help with low male hormones is progesterone cream. When progesterone is absorbed by the skin it can be converted into other sex hormones including testosterone. Additionally our bodies can naturally convert progesterone into adrenal hormones found to be low in CFS patients. Further, progesterone administration can correct symptoms of an underactive thyroid including chronic fatigue and muscle aches and weakness.
Life-style chances may assist as well since smoking, excess alcohol consumption and drug abuse can reduce testosterone levels. Exposure to excessive physical and emotional stress should also be controlled if possible as this can negatively impact male hormones. Some also encourage trying to avoid exposure to household chemicals and environmental toxins such as pesticides and synthetic foods because these have demonstrated anti-testosterone effects.
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