Cuban medical Advances, Andropause and its Therapy
By Heidy González Cabrera, Photos: Alejandro Gortázar & Jorge Pérez
Andropause, or male menopause, is something that most men are reluctant to talk about even though it is the natural process of declining virility due to age. The condition is also called Viropause or Androgenic Deficiency in male aging and is the result of low levels of testosterone in the body.
Similar to female menopause, hence its comparison, males start losing sexual potency but maintain the production of spermatozoids so procreation is possible even at an old age.
Symptoms include insomnia, depression, nervousness, anxiety and irritability, a decrease in libido, bone deterioration, circulatory problems, and damage to the skin and hair.
Nevertheless, there are other factors that can have an influence on virility and are confused with Andropause: Monotony - The lack of stimulation caused by a poorly varied sex life can lead progressively to a lack of interest in sexual activities.
There are some people who try to find the solution with a younger partner as a way of temporary or permanent stimulation, without understanding that the important thing is to change the attitude towards sex, independent of the age and nature of the partner.
Anxiety and Stress - Work, economic, and domestic problems can reduce the interest in sexual activities between the age of 40 and 70.
Also, repeated and prolonged trips during which the couple is separated decreases the interest in intercourse and effectiveness.
Loss of a partner - The "widowhood syndrome" results in the case of an elderly person who is in a period of almost total sexual inactivity. In later stages, if he has a desire for a new partner, he may suffer erectile dysfunction.
Diseases - It is obvious that diseases have a negative influence on sexual activity. Many types of afflictions that weaken the body or affect the psyche can damage sexual activity.
Certain types of medications also damage the libido and sexual potency such as those for arterial hypertension, cardiovascular disorders, and mental disorders.
Alcoholism - It is one of the factors that have the most negative influence on sexual function. Metabolic and hormonal changes affecting the whole body, especially the central and peripheral nervous system, can cause erectile dysfunction and depress the libido. Alcohol abuse can cause a decrease in testosterone, extra-pyramidal tremors, alcoholic neuritis, vitamin deficiency, and hypoglycemia. Small amounts of alcohol can cause a tranquilizing effect and can be favourable for intimacy.
Performance Anxiety - Adults older than 50 often have a fear of failure, either erectile dysfunction or not doing it "right." There is a false belief that at that age sexual potency is inadequate for greater demands. Prevention and Therapies Scientists around the world working in this field share the opinion that we cannot say that the prevention of Andropause actually exists. One can say that the knowledge of the negative factors that influence sexual health and having an adequate comprehension of the physiological events in maturity helps.
The previous statement is acknowledged by Dr. Manuel Licea Puig, Cuban endocrinologist and researcher, who points to what is nowadays considered a controversial therapy, Androgenic Hormone Replacement Therapy (HRT). This therapy does have certain contraindications and requires medical examinations and tests including prostatic evaluations and the determination of specific prostatic antigens, levels of cholesterol and plasmatic triglycerides, blood cell count, and a study of hepatic function. As an expert from the Cuban National Institute of Endocrinology, Puig states that in the case of patients with breast or prostate cancer the use of Androgenic HRT has absolute contraindications. Among the relative ones are: prostatic benign hiperplasy (growth in breast volume), alterations of hepatic functions, and sleep apnea.
Regarding the use of the popular Sildenafil (Viagra), it can be seen as an alternative for the treatment of erectile sexual dysfunction (sexual impotency) although it is contraindicated for people under nitrate treatment. There are several Androgenic medications in different research and clinical stages with the aim of making the lives of aging men better and which offer greater safety. Many long-term studies of HRT are being conducted to establish with greater precision the risks and real benefits of this treatment.
Appropriate therapeutic evaluation and therapy for Andropause is a service, like many other medical specialties, that is offered to foreign patients in different institutions in Cuba.