“Climacteric Period” of Men in the Discussion -- MEDICA - World Forum for Medicine

“Climacteric Period” of Men in the Discussion

Photo: Man at a physician

Men are ill more frequently but they
go to a physician less frequently;
© Hemera

Viagra made it possible: erectile dysfunctions mostly belong to the past. Since the launching of the blue pill 1997 the interest on andrology increases. Healthy problems of the man were displaced for a long time because they did not fit to the picture of the “stronger sex”. Today they are open discussed. And the look has dilated. It is not only about erectile dysfunction, but also about disorders in fertility or questions to male contraception. Even the climacteric period should have received the man – this is what you can read in the media. But strictly speaking this discussion is not so new how it looks at first sight.

"In the early 20s physicians explained healthy problems of the man in the middle of his life as nervous suffering”, explains Dr. Hans-Georg Hofer from the Medicine Historical Institute of the University of Bonn. The discussion about a climacteric in men, a turning point in life, could be followed back up to the antiquity, says Hofer. “From a climacteric period as a change of hormones people speak only since 70 years“, says the medicine historian. The hormone testosterone first was discovered in the 30s.

"Men’s Health" instead of "Playboy"

The reasons to the stronger interest on andrology for recent years are different. Professor Theodor Klotz, clinic for urology, andrology and children urology at the Clinical Centre in Weiden, Germany, and member of the managing committee “German Society for Man and Health” talked about healthy emancipation. The reason: The picture of men has changed. “40 year old men go to fitness companies of course. 15 years ago this was different. While today well-conditioned bodies on “Men’s Health” serve as a model, a few years ago men would have drunk bear and flicked through the “Playboy”.

But there are also medical reasons therefore that men’s health comes to the fore. “10 years ago there was observed doublethink: Although women go to a physician more frequently, men appear to be more vulnerable", explains Klotz. Studies prove that men more often have cancer and that they die seven years earlier on average. The explication: 40 percent of the women make use of preventive medicine, but only 16 percent of men.

The pharmaceutical industry also is interested in climacteric period in men. It keeps an eye on the social ambition to youth and vitality – and hopes for benefit. Business organisations praise hormone compounds as fountain of youth with which the time could be turned back. “Men between 50 and 60 are a well-funded target group. Because many of them have problems to adhere to their age, the market works”, explains Hofer.

Hormone therapy is not a fountain of youth

To many experts it is too unprofessional to talk about a male climacteric period. Fact is, that between the ages of 40 to 60 the level of testosterone falls in many men. The consequences can be a loss of libido, depressive displeasure, muscle weakness or decreased productivity. “While every woman gets into climacteric period, only about 20 percent of men around 50 years are concerned of a detectable fallen level of hormones”, explains Klotz. By the way this proceeds slow and not abrupt like in women. Another difference is that women lose their fertility with the climacteric period while men stay potent up to great age. Based on these differences physicians rather talk to andropause or Partial Androgen Deficit disorder in Ageing Men (PADAM).

But it is controversial if the hormonal change should be treated. Hofer talks about a normal process of ageing in men. Hormone compounds could not change this and therefore they do not make sense. However, Klotz says, the treatment depends on the right indication. “There are hormone compounds which can be beneficial for men.” A rejuvenating cure could not be achieved but if afflictions could be alleviated this would have effects on well being. Perhaps men feel younger, Klotz added. Although hormone deficit depends on age it could be treated. “In medicine many afflictions which depend on age are treated. The artificial hip joint is only one among many examples. Well, why should hormone deficit in men not be treated?”

To warn against abuse of hormone products Klotz does also like Dr. Ilka Goschütz, female andrologist on the Urban Hospital of Görlitz, Germany. “In the USA such products are on sale as lifestyle products. Fortunately this is not so in Germany.” Similar as hormone replacement therapy for women in climacteric period hormone compounds for men have to be seen critically. “The risk to develop prostate cancer should not be undervalued”, she explains. That is why effect and side effect should be balanced accurately.

Interest on men’s health increases

Men’s health attracts wide interest in general. Klotz watches this. “In the ‘German Society for Man and Health’ are colleagues from 1000 special subjects by now”, he explains. In spite of that it is a matter of a slow process. Since the beginning of the 21th century physicians can improve oneself to an andrologist. And only at the University Hospital of Hamburg Eppendorf is a chair of men’s health – the unique in Germany.

Simone Heimann