Saturday, Dec 14, 2019

Male menopause

Ninety percent of men will have some form of erectile dysfunction in their life, and the joke commonly passed around by urologists is that the other 10 percent are lying about it.

“So 100 percent of men at some time in their life are going to have erectile dysfunction,” says Urologist Dr. Greggory Pinto.

But he says that sadly for most men the erectile dysfunction goes on for five … eight … 10 years before they have the initial confidence to confide in a urologist who can easily help them, not only in terms of prescribing Viagra or Cialis, but to determine the organic cause of the erectile dysfunction.

“A lot of times it’s undiagnosed diabetes or poorly controlled diabetes, or it might be uncontrolled hypertension — and a lot of hypertensive medication that’s commonly prescribed are libido killers. They cause erectile dysfunction,” said Dr. Pinto at the recent Doctors Hospital Distinguished Lecture Series. “We can change the medication that they’re one and still effectively treat your hypertension and give you back your erection and libido.”

Dr. Pinto was scheduled to speak on urinary problems which he did, but also took time out to address male menopause. He says erectile dysfunction is an epidemic in The Bahamas mainly due to uncontrolled diabetes.

“Once a man reaches [age] 50, they’re going to go through what is commonly called the male version of menopause. They’re going to have the male metabolic syndrome where they’re going to develop hypergonadism; their testosterone is slowly going to fall over time. The number one complaint they’re going to have is erectile dysfunction.”

Dr. Pinto says low testosterone has many terrible life events affecting health.

He said the male will put on weight, despite their activity, and despite their diet, and will develop a beer belly even though they’re not drinking beer.

“They’re going to be fatigued, and have a lack of energy. Their spouse may be saying they’re moody or depressed, and they fall asleep while watching Sunday football in the afternoon. Low testosterone can change you completely.”

He said things males used to love to do they no longer enjoy, they don’t have the energy to play with their grandchildren anymore and they don’t have that interest or libido for sexual activity, which can affect their self-esteem.

He encourages men to go to the doctor.

“If we can check your testosterone, we can supplement your testosterone at the same time, we can check for prostate cancer, because you cannot give someone with prostate cancer, testosterone. Testosterone as a hormone is needed to proliferate and for prostate cancer to progress. So if someone presents with erectile dysfunction, that’s the perfect time for a urologist to check someone for prostate cancer.”

Sam Smith (name changed) 53, who was diagnosed with Type 2 diabetes, hypertension and high cholesterol at age 39, has had erectile dysfunction interfere with his life to the point where he says he became depressed. But he initially thought his lack of interest in sex and ability to achieve erection at the time was due to his diabetes.

“My eyesight started bothering me, and was coming and going. I was peeing a lot, and wasn’t interested in sex. I was returning home from an overseas trip, and fell asleep on the return flight back from Florida and felt weird. I went to the hospital, and my sugar was 800.”

At the time, Smith had been a pack-and-a-half cigarette smoker for 20 years, did not exercise, worked 14-hour days, consumed lots of sugary drinks and drank no water. He also had no interest in sex.

“I was a walking time-bomb,” he recalled. “I told the doctor that I wasn’t interested and couldn’t get an erection. He prescribed medication, told me to stop smoking, which I quit cold-turkey the next day, 14 years ago.”

Three months ago, Smith said he saw manifestations of a lack of sex creeping back into his routine again and immediately went to the doctor, who prescribed supplements for him. Three weeks ago he did a follow-up, and was told that his symptoms were leveling out as far as his low testosterone. But he also learnt that his cholesterol, hypertension and diabetes were all well controlled.

“I would suggest to guys if your body isn’t functioning properly and normally, it’s an indication that something is wrong. Plus when a man turns 50, it’s just a part of the normal aging process, so go to the doctor and get a full blood workup.”

Smith said since his scare on the plane and his first brush with erectile dysfunction, well before his half-century mark, he makes it a point to have full checkups done.

“Once the doctors find a problem, it’s easy to fix with medication and exercise,” he said.

“I take better care of myself now at age 53, than age 23 because I’m more in tune with my body now.”

Taking better care of himself, he said he’s also noticed he’s lost weight, with moderate exercise.

In coming to grips with his most recent brush with erectile dysfunction, Smith said it also helped that he had a supportive wife by his side even though he went through a depressive period for a week.

“You have to have a supportive wife to figure things out and say let’s find out what the problem is, because you had an erection last week, and this week things aren’t working. Today, I want to know.” Most men don’t want to know, but it’s part of the natural aging process.

While the term male menopause is sometimes used to describe the decreasing testosterone levels related to aging, female menopause and the so-called male menopause are two different situations.

In women, ovulation ends and hormone production plummets in a relatively short period of time; in men production of testosterone and other hormones declines over a period of many years.

Shavaughn Moss

Lifestyles Editor at The Nassau Guardian
Shavaughn Mossjoined The Nassau Guardianas a sports reporter in 1989. She was later promoted to sports editor.Shavaughn covered every major athletic championship from the CARIFTA to Central American and Caribbean Championships through to World Championships and Olympics.
Shavaughn was appointed as the Lifestyles Editor a few years later.

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