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New testosterone drug rekindles debate over 'male menopause'


June 14, 2000
Web posted at: 3:45 p.m. EDT (1945 GMT)

ATLANTA (CNN) -- Men who are deficient in testosterone now have a more convenient way to take the male hormone: a topical gel called AndroGel. It became available for sale on Wednesday.

Testosterone drugs are nothing new; shots and skin patches have been available for years. But this new form -- a prescription gel that's rubbed into the skin -- has re-opened a debate over who should take hormone supplements.

Some men need testosterone to treat a medical condition -- some pituitary disorders, for instance, can make testosterone levels plummet.

But should healthy men take testosterone because they want to feel younger? Men's testosterone levels gradually decline with age, starting in the mid-30s. The change is sometimes called "male menopause," or andropause, meaning a decrease in male hormones.

Dr. Lisa Tenover, a geriatrician at Emory University, said doctors need to be careful prescribing testosterone. Supplementation has been linked to strokes.

"We don't yet know the long-term risks," she said, "and that's where I'm most concerned."

A British physician said he's prescribed testosterone to hundreds of men who were otherwise healthy, just not very happy.

"They're sick and tired of their lives. They're sick and tired of their families. They're sick and tired of their jobs, and this can be turned around," said Dr. Malcolm Carruthers of London. At 62, he takes testosterone himself.

"About 10 years ago, I was feeling tired and pretty grumpy myself," he said. "And generally my zest and drive dropped quite a bit."

He predicted testosterone-replacement therapy for men one day will be as common as hormone-replacement therapy for women is now. And, Dr. Carruthers said, the hormone therapy will be offered to fight the natural changes of getting older.

According to the distributor, Unimed Pharmaceuticals, Inc. of Buffalo Grove, Illinois, AndroGel should not be used by men with breast or prostate cancer and women should never use it.

Andropause is less well known than menopause, the hormonal changes that cause a woman's menstrual cycle to stop.

In his book, "Male Menopause," Jed Diamond said the phase "begins with hormonal, physiological and chemical changes that occur in all men generally between the ages of 40 and 55, though it can occur as early as 35 or as late as 65. These changes affect all aspects of a man's life. Male menopause is, thus, a physical condition with psychological, interpersonal, social and spiritual dimensions."

Common symptoms of male menopause, according to Diamond, include needing longer to recover from injuries and illness, less endurance for physical activity, weight gain, thinning hair, sleep disturbances, irritability, and reduced interest in sex.

CNN Medical Correspondent Elizabeth Cohen contributed to this report.

Are You Man Enough?
April 24, 2000
Study links male baldness to heart risk
January 24, 2000
Testosterone: The good and the bad
December 3, 1999
Steroids build muscle mass, not aggression new study says
July 3, 1996

Unimed Products: AndroGel
What is Male Menopause?
Male Menopause

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