Male menopause down to more than work-related stress
While 'andropause' might sound like some newfangled headache treatment, it actually causes pain, rather than relieving it.
Andropause - or male menopause, as it's better known - is an affliction that is greeted with frustration, fear and scepticism by men nearing middle age.
There's no way to prevent the condition, there is no cure, and doctors still can't explain why some men get it and others don't. All that's known is that it is real and it affects a significant proportion of the male population.
Peter Ho Chun-kit, a urology consultant with the Adventist Hospital, suggested that men might want to test their hormone levels if they have six or more common symptoms of andropause: decrease in strength and endurance; lack of energy; decrease in sex drive; depression; decrease in height; lower enjoyment of life; deterioration in the ability to play sports; recent deterioration in work performance; weaker erections; and, falling asleep after dinner.
Dr Ho said that, although many of the above sound simply like symptoms of work-related stress, it's still important that people get regular check-ups - something men are notoriously bad at.
'They usually have to be dragged in by their wives, unless there's something really acute going on,' Dr Ho said. 'Otherwise, they don't come for regular checkups, so they don't have a chance to tell the doctors about the things going on around them.
'Pressure at work can often amplify the symptoms. Often people confuse andropause with stress- related problems.'
Most people refer to andropause as a mid-life crisis, and some men still think the cure is a sports car or a younger partner.
'But andropause is something with real physiological symptoms and real physiological causes,' Dr Ho said. 'When we test men's blood, we find their testosterone levels are low. If people have andropause and if their energy level is down, they just can't handle the stress at work, as well.'
Dr Ho estimated that about 20 to 30 per cent of men over the age of 50 experienced andropause. The drop in hormone levels is about 10 per cent each decade from the age of 30.
'People believe more in [female] menopause because women have more acute symptoms such as the cessation of menstruation,' he said. 'But men's symptoms, such as sexual dysfunction, are more insidious. Most victims are not even aware they are experiencing it.'
The urologist said there was no scientific proof that men in big cities were more vulnerable to symptoms of andropause than those living in 'less stressful environments', such as farmers.
'If you're a farmer in the field, then your body faces different pressures to people in the city.
'Andropause probably doesn't affect you as noticeably as it does the chief executive of a big company who has to watch the stock prices everyday.
They have more problems to deal with, but at the same time they don't have enough energy to cope with it,' Dr Ho said.
Annie Kung Wai-chee, professor of the division of endocrinology at the University of Hong Kong has tested the hormone levels of 503 healthy local men since 2001.
She found that 29 per cent of the men, aged between 50 and 96, had low readings - which is comparable with the figures cited by Dr Ho.
She said that, while some men maintained a high level of testosterone throughout their lives, others found andropause setting in before 50, sometimes as early as 30.
'However, there's no good data in Hong Kong to pin down the prevalence of andropause among men in Hong Kong or to help doctors better understand the symptoms,' she said.
Professor Kung said doctors were cautious about prescribing hormone replacement therapy for men, a practice that has proved controversial in women, because there's no body of medical research on its possible side effects, such as its links to prostate cancer.
Ng Cheuk-lam, vice general secretary for the International General Chinese Herbalists and Medicine Professionals Association, said it was possible to address the symptoms of andropause and menopause using traditional Chinese medicine.
However, both Dr Ho and Professor Kung said they wouldn't recommend any treatments that weren't backed by scientific evidence.
'Under these circumstances, we don't really know how to handle andropause, so many doctors try to avoid the issue or test their patients' male hormone levels unless they have severe problems with their sex life,' Professor Kung said.