Supermale Syndrome: 50s and Beyond

News Article
Supermale Syndrome: 50s & Beyond
Thursday, 20 l 05 l 2010 ; Source: Mind Your Body; The Straits TImes
By Geraldine Ling
Age: 50s & beyond Testosterone woes Male testosterone levels continue to drop. By about age 70, the decrease in a man's testosterone level can be as much as 50 per cent. When testosterone levels drop below normal levels, this condition is called late-onset hypogonadism. Hypogonadism is a term used to describe a developmental disorder of puberty when boys fail to develop secondary sexual characteristics, such as body hair and the thickening of vocal chords, because of low levels of testosterone. However, there are also some mature males whose hormone levels fall below the normal range for their age, hence the term late-onset. A survey published this year, conducted by the Society for Men’s Health Singapore, questioned 1,500 men to check for the prevalence of hypogonadism. It found that some 26 per cent of respondents had the condition, up from 9 per cent in 2002. The mean age of those who had hypogonadism was about 55. Late onset hypogonadism is more than just about sexual problems, said Professor Peter Lim, a urologist and the founding president of the Society for Men’s Health Singapore. Left untreated, it can lead to significant consequences on men’s health, like hypertension or diabetes, he said. Diagnosis is usually confirmed through blood tests. Hormone replacement therapy is the standard treatment for late-onset hypogonadism. It can be taken orally or administered through patches or injections. Testosterone levels can also be boosted through regular exercise like brisk walking, said Professor Kesavan Esuvaranathan, a senior consultant at the department of urology at the National University Hospital. Prostate problems Prostate gland enlargement, or benign prostatic hyperplasia (BPH), is the most common prostate problem in Singapore as men grow older. Up to 50 per cent of screened men aged 50 and above have at least one symptom of difficulty in urinating. It is typically caused by BPH, said Prof Kesavan. The prostate is a walnut-sized gland found just below the bladder in men. It makes some of the milky fluid, or semen, that carries sperm. What causes it is unknown, but symptoms include a weak urine stream or the frequent or urgent need to urinate. Treatment includes drugs or surgery. Prostate enlargement can also be caused by prostate cancer, which is the fifth most common cancer in Singaporean men. It is usually curable when detected early, but can kill if diagnosed late or not treated effectively. The cancer is prevalent in men who are in their 70s or 80s, said Prof Kesavan. It is usually treated through surgery and radiation therapy. Hormone therapy may be used as prostate cancer cells rely on testosterone to help them grow. Chronic diseases Men start to really pay for their health mistakes once they hit their 50s, said Dr Tan Kok Kuan, the chief medical officer of The Men's Clinic. For example, a smoker in his 40s with hypertension, who refused to kick the habit then, may end up with heart disease now. In terms of cancer, colorectal cancer is the most common cancer in men here and the most prevalent one in Singapore. Men aged 50 and above are encouraged to go for colorectal cancer screening, said Dr Tan. Depression Men over the age of 65 face an increased risk of depression, said Dr Thong Jiunn Yew, the medical director and consultant psychiatrist at Nobel Psychological Wellness Clinic. This is the age when many would have retired. As men usually identify with their job and breadwinner role in the family, relinquishing their career may cause them to feel stressed, he said. Depression may also partly be caused by the new health challenges faced by ageing men, he added. Certain medical conditions, like heart disease and stroke are associated with the development of depression. In addition, men may worry about their impending mortality and dependence on others. Men also have to endure the loss of friends and family over the years. This predisposes them to grief and may lead to depression in some men, he said.
Seeking the fountain of youth Oh, to feel young again. In some developed countries, there are anecdotes of older men turning to testosterone therapy in a bid to restore their youth and vitality. After all, the possibilities of the hormone replacement therapy seem enticing – testosterone helps maintain sex drive, muscle strength and promotes an overall sense of vigour and well-being. Testosterone levels peak during adolescence and early adulthood. However, once past the age of 30, the hormone starts decreasing. For some men, low testosterone levels may cause a reduced sexual desire, insomnia, weight gain, brittle bones and depression. So should men turn to testosterone therapy for their second spring? The answer is no. Testosterone therapy should never be used to boost libido or to make men feel great and strong, cautioned Professor Peter Lim, the president of the Society of Men’s Health in Singapore. The only indication for its use in adults is for the treatment of late-onset hypogonadism, he said. The American Association Of Clinical Endocrinologists’ guidelines for the treatment of hypogonadism advised that patients should be on testosterone therapy only when there is proven deficiency. If a patient takes more of a hormone than the body requires, the body may shut off its own production. Other dangerous side effects include a possible increased risk of prostate cancer and blood thickening, which can increase the risk of stroke.