Accessories

An Honest Appraisal of Male Hormonal Decline and Treatment
The Andropause Mystery, Unraveling the Truths About the Male Menopause by Robert S. Tan M.D.

In this book, Robert Tan MD , an astute clinician and a board certified specialist in geriatric medicine, describes his professional experience, diagnosing and treating hormonal decline in aging males. Tan describes a turning point in his career when he stumbled upon a bedridden male with the typical signs and symptoms of low testosterone, namely muscle weakness, frailty, memory loss, and hair loss. Lab testing confirmed low testosterone levels. Testosterone for aging males was new in those days, so Tan had difficulty convincing the pharmacy to release the testosterone injections ( 200 mg twice a month). After three months of injections, the patient grew a beard, began walking again, and his memory and libido improved.

The experience motivated Tan to do a Medline search on the topic, and he found very little research in the area of Male Menopause, also called Andropause. This book was written to unravel the truths and dispel the myths about the Male Andropause and Testosterone replacement for the aging male.

Tan asks a few obvious questions. The medical system treats women for the hormonal decline of Menopause, so why aren't men treated for their similar hormonal decline of male Andropause? The medical system recognizes Menopause, but does not recognize Andropause.

Many physicians deny that Andropause really exists. Tan says sorry, but it does exist, and his patients are testimony to this truth. Andropause is a real syndrome, and he clearly explains that 30% of males over 65 have low testosterone levels with the associated muscle weakness, memory loss, and loss of libido. Tan also explains the reasons why the syndrome is ignored by conventional medicine. There is no curriculum in medical school or residency, and very little research in the library due to lack of funding, and lastly, unlike females who are more expressive and communicative about their night sweats and hot flashes, males tend to be stoic, and in denial of their Andropause symptoms.

Tan discusses the beneficial affects of testosterone on cognitive function, finding that many (but not all) demented nursing home males are restored to normal after testosterone treatments. He also discusses the effect of testosterone on mood, cardiac function, muscle strength, bone density, and lastly improvement in libido and erectile function. In one humorous story, Tan recounts a demented nursing home patient whose testosterone treatment had to be discontinued because of hypersexual effects. Apparently, the old fellow had approached several nurses with inappropriate requests.

Tan also discussed the incorrect belief that Testosterone treatment increases the risk of prostate cancer. Tan dispels this myth, stating that in his clinical experience, he has yet to see a case of prostate cancer induced by testosterone replacement. Nonetheless, Tan advocates routine prostate surveillance with serial PSA and DRE.

Chapter 7 discusses the nuts and bolts of testosterone replacement with diagnostic blood testing, available testosterone preparations and dosage schedules. Tan feels that testosterone replacement for males should become as routine as HRT for the female menopause.

Inconclusion, in a field with scant information, Tan's book fills a void. The book is an honest, courageous, down to earth, and occasionally humorous look at testosterone replacement for the aging male. Also recommended is The Testosterone Syndrome by Eugene Shippen MD.

Jeffrey Dach MD

Not what I expected.
What I thought I bought; a book about the aging process and the Andropause. What I got; mostly a book about testosterone replacement. This book was a let down.

Hidden Sexuality Phases of Men
The bravado of patriarchy and its reliance upon presenting males as strong, vibrant creatures able to take on the world when young, and equally powerful when old has always been a myth perpetuated as the alpha male syndrome.

However, the reality is that, like women, men undergo similar hormonal changes as a result of aging. While the outward appearance of men may remain somewhat similar, both personality and hormonal changes occur along with the physical changes in muscle power that young men discern readily in challenging the older male establishment for power and prominence.

Little discussed, or viewed as the natural aging phenomenon of men and the mellowed perspective in which he sees the world, and operates in it, typical male menopause has focused upon his desire to grativate toward younger women to extend his male prowess, or by making the wild changes of adopting fast cars, and more relaxed lifestyles in an attempt to capture his youth.

That males haven't come to grips with the similarities of aging among women ought to be a concern since so much of society is organized not around the vitality cycles of natural aging, but by the fantasies of aging men who deny their own mortality, and the consequences of aging. Taught to view women differently, men therefore find it more difficult to accept their own aging process because of the enormous differences in how men and women are cultured to be viewed by a male dominant society.

Because men died at somewhat younger ages throughout life, the lifecyle phenomenon of men has never been approached with the legitimacy or credibility that is a part of the natural consequence of being male.

That either men or women are taught to view the aging process as one that is devalued because of its physical changes rather than prized for its contribution to stable and sustainable populations is a social problem that has yet to be taken seriously. When country singers sing that "all my rowdy friends have settled down," they are recognizing this natural tendency of men to settle into a lifestyle that accepts their aging as natural, and normal rather than continuing to idolize the rowdy lifestyle that the constant pumping out of male testosterone helps to create.

The message, of course, is that, like women, men will not live forever, do suffer the consequences of aging, and must adapt age appropriate lifestyles that respects their aging, rather than condemns it. That attitude will work for both men and women to help define the expectations of being human, and mature as individuals, in planning their lives and knowing what to expect from their bodies, and what not to expect.

For the layperson
This book is really for the layperson. The book "Andropause Mystery" does describe evolving physical, sexual, psychological and mental challenges encountered by the aging male. It does explain hormone replacement for men and the potential problems. There is a nice chapter on the psychological impact of aging on sexuality. It is easy to read and understand, but I prefer "Aging Men's Health: A Case Based Approach" by the same author. No doubt, it is a textbook, but there is more depth and detail for the professional person.

NBC Nightly News with Tom Browkaw
I couldn't believe it! The controversy about hormones for women has begun, now men? The book and author was featured on NBC Nightly News on 7/31/02. Guess it must be an important topic to be on national news!