Men’s Health & Fatigue

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Men tend to delay seeking help for health issues and frequently put up with symptoms  rather than addressing them. Hormone issues can occur in men, affecting health and well-being and causing fatigue. Men do not experience a menopause in the way that women do, but male hormone production can be affected by several different medical conditions including testicular and pituitary disease. Diabetes mellitus can also interfere with male hormones and sexual function. Men suffering from prostate cancer may be given treatment that blocks male hormone production. In otherwise healthy men, testosterone levels decline with age, and if this decline is very marked a condition sometimes described as “male menopause” or “andropause” can occur resulting in symptomatic effects of low testosterone.

A low testosterone in men can cause reduced sex drive, erectile dysfunction (reduced erections), reduced muscle mass and increased fat mass (especially of central distribution around the middle), muscle weakness, fatigue and mood swings. A persistently low testosterone can also result in abnormal fat content in the blood and reduced bone density and strength. If low testosterone levels are detected in men with these symptoms a trial of testosterone replacement is sometimes offered under expert supervision after a safety assessment. Testosterone replacement therapy has been shown to significantly to improve quality of life in men with testosterone deficiency.

If you think you may have a low testosterone you should discuss this with your primary care doctor. Simple blood tests can be arranged to check whether you have a hormone problem. The doctor will often check the male hormone (testosterone) and two pituitary hormones (LH & FSH) initially. These tests need to be done at around 9AM because of the diurnal variation in testosterone levels. If the testosterone level is low further tests will be needed and you may need to be seen by an endocrinologist for further assessment, investigations and treatment.

For more information about male sexual health problems visit UptoDate on-line male hypogonadism resources patient centre.

Dr Annice Mukherjee, Hormone Consultant & Fatigue Expert