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'Male menopause': Is it fact or fiction?

Mid-life fatigue, moodiness, more fat, less muscle and a decline in libido — symptoms common to women in menopause, but they're not alone.

CLEVELAND — All women, at some point in their lives, go through menopause. Their reproductive hormones reduce to the point they become infertile and can no longer have children. 

As for men, that's not the case. 

"It doesn't happen as abruptly," Dr. Nannan Thirumavalavan, chief of male reproductive health at University Hospitals Cleveland Medical Center. "There's not one time point where the switch turns off and you stop having testosterone, it happens kind of gradually as men age."

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Unlike women, men can still be fertile, or may not notice any significant symptoms or changes at all.  For that reason, we say women go through menopause, while men may (but not always) experience a condition called "andropause," or better yet "testosterone deficiency."

"Testosterone deficiency basically refers to a situation where a man's body is not producing enough testosterone for what his body needs," Dr. Petar Bajic, assistant professor of urology at Cleveland Clinic Lerner College of Medicine, told 3News/

One reason for the nickname "male menopause" — or "man-o-pause" — is because many of the symptoms are the same for both sexes. 

"Feelings of being tired or sluggish is one of them," Thirumavalavan says, [along with] decreased energy, and, in general, a decreased sex drive or libido. You can also notice some physical changes, like a decrease in muscle mass or increased fat mass."

Treating a testosterone deficiency can be relatively easy. There are several treatments your physician can prescribe, from gels, injections, a pill for testosterone, a nasal spray, or even pellets injected right under the skin and dissolve over time.

However, doctors first need to make sure something else isn't to blame for the symptoms. 

"If a man is experiencing these issues, there seems to be a tendency to look for an easy fix," Bajic explained, "but really, we need to get to the bottom of what the problem is."

Some causes could be linked to diabetes, weight gain, or undiagnosed sleep apnea. 

"Don't hide things; you can't get help unless you kind of know what's going on or your doctor knows what's going on," Thirumavalavan said. "Even at a young age, we're seeing some medical problems crop up, and we're able to treat them and make a quality of life better overall."

These days, you can't turn on the radio, TV, or open a magazine without seeing pills for a stronger libido advertised or erectile dysfunction medicine prescribed online. Both doctors say to be careful, because they may be a bad idea. 

"These direct-to-consumer services do not do as good of a job of getting to the root of what the problem is and performing those really important diagnostics to figure out," Bajic noted. "Maybe you do have underlying cardiovascular risk factors. They could, in a couple years, lead to a heart attack. Maybe you do have some underlying hormonal issue that we can fix, so it's important that men know this and [to] not look for those easy fixes and really make sure you have a primary care doctor that's checking your overall health."

Both doctors emphasized sleep could be a root cause of some of these problems — especially for third shift workers such as firefighters and police officers — because when the circadian rhythm is off, it can lower testosterone. 

And while many men may be reluctant to see their doctor to discuss issues like libido, experts are seeing a different shift in younger men. They seem more open and willing to seek help. 

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