Sleep Disturbance: Male Menopause Symptoms

Sleep disorders represent one of the most annoying and potentially debilitating symptoms of Andropause. Long-term persistent lack of adequate sleep can disrupt daytime activity, affect job performance and general lifestyle, and trigger multiple health related physical and emotional problems in turn. Fortunately, most common cases of sleep disorders are preventable and treatable through lifestyle and diet changes, medications, and hormone replacement therapy as last resort.

Male and Female Differences in terms of Sleep

Differences in sleep patterns between men and women are found throughout the ages, and it is confirmed that men are more likely to suffer from sleep disturbances such as snoring and sleep apnea amongst others, than women are.

The traditional picture of the male sleeping anywhere or falling asleep on the sofa may not be just a joke. Recent research has shown that men may in fact sleep better alone. When men and women were tested for cognitive ability and levels of stress after sleeping together, the men fared worse than the women. The men appeared to be more disturbed when sharing a bed than the women, while the women enjoyed a better night's sleep.

Another major difference between men and women is related to the fact that men frequently fall asleep immediately after the intercourse, while women may stay awake for long. That created many jokes and multiple family conflicts, while women were accusing men in lack of feelings. However, it was scientifically proven that there are many reasons for men to fall asleep straight after sex, and that is nothing to do with attitude to the partners.

One supposition is that men have sex at night and the combination of daytime exhaustion and muscular tension followed by deep relaxation induces sleep. Another is that prior, and during ejaculation, men hold their breath for a short period and readjustment causes changes in breathing that create deep relaxation, encouraging sleep.

Whatever the reason, it appears that sex is a good prelude to falling asleep for men and not the best time for conversation. Women may feel more stimulated after sex and find it harder falling asleep. An awareness of the affects of sex on both partners will help maintain harmony in the bedroom.

According to researchers from the Penn State University lack of sleep can be fatal for men. Surprisingly, women were not significantly affected by lack of sleep. Researchers studied for more than a decade 2,000 men and women, examining their sleep patterns in a sleep laboratory. They found out that men who slept for only 5-6 hours a night had five times higher risk of dying from medical complications. In comparison to those who slept 6 hours or more.

Sleep Stages and Aging

Normal sleep has different stages that cycle throughout the night. Sleep specialists classify these as rapid eye movement (REM) sleep and non-REM sleep.

• REM sleep is the stage in which muscles relax most completely. Dreaming occurs during REM sleep.
• Non-REM sleep is subdivided into 4 stages. Stages 1 and 2 constitute light sleep; stages 3 and 4 are called deep sleep. Deeper sleep generally is more refreshing.

Sleep changes with age. Older people are less efficient sleepers and have different patterns of sleep than younger people.

·         The duration of REM sleep decreases somewhat with aging.

·         The duration of stage 1 sleep increases, as does the number of shifts into stage 1 sleep. Stages 3 and 4 decrease markedly with age in most people, especially men. In people aged 90 years or more, stages 3 and 4 may disappear completely.

Common Sleep Disorders

Men at Andropause are experiencing significant sleep disturbance patterns, making it hard to impossible to sleep properly through the night. The most common sleep disorders include:

• Insomnia: Inability to fall asleep and/or waking up frequently on a regular basis.
• Sleep apnea: Cessation of breathing during sleep (often accompanied by snoring).
• Night sweats: Nocturnal hot flashes (sudden sensation of intense heat, perspiration, flushing) that disrupt sleep.
• Restless Leg Syndrome (RLS): Irresistible urge to move the legs during rest, often experienced as an itching or spasmodic sensation. This is a neurological condition that is rarer than the other symptoms.
• Narcolepsy: Daytime "sleep attacks".
• Other: Other sleep related problems include nightmares, night terrors, sleepwalking, sleep talking, head banging, wetting the bed and grinding your teeth. Such sleep problems are called parasomnias.

Sleep Apnea

The menopausal causes of sleep apnea and insomnia in men often vary significantly from the causes of insomnia in women. The low testosterone associated with andropause largely contributes to sleep apnea in men, leading to insomnia or sleeplessness. Sleep apnea is the interruption of or difficulty breathing during sleep. It is a sleep disturbance where a short period of oxygen deprivation to the brain means numerous awakenings during the night. This means that sufferers may be getting less REM sleep. REM (Rapid Eye Movement) sleep is the light sleep where dreaming occurs. Sleep apnea affects approximately 9% of adult males and is more common in obese males. The inhibited breathing and loud snoring common of sleep apnea tends to disrupt sleep many times throughout the night.

Insomnia in men resulting from low testosterone and sleep apnea can lead to several other problems including fatigue, reduced insulin sensitivity, low human growth hormone levels and high cortisol levels. Cortisol, the stress hormone, will increase with prolonged insomnia because of the stress on the body. Constant high levels of cortisol can create a hormone pattern that further reduces testosterone production. It can also lead to adrenal fatigue which often worsens the fatigue and insomnia.

Human growth hormone is naturally made during the first 90 minutes of sleep. Therefore, if your sleep is disrupted, your growth hormone production is reduced. This can lead to lower levels of testosterone and reduced lean muscle mass. Sleep is also very important for proper insulin sensitivity and glucose control. If sleep is disrupted, the body stops utilizing insulin as effectively and the body begins to need more and more insulin to control blood sugar. This leads to weight gain and a pre-diabetic state that, if not well managed, can lead to diabetes. Research has also discovered a connection between sleep apnea and erectile dysfunction.

Alcohol and smoking affect sleep and should be limited. Caffeine, large meals and heavy exercise are best avoided before bedtime. Anxiety and stress are part of life but by learning how to relax some of the physical and emotional damage can be avoided. Lack of sleep may be inevitable at certain times but by being sensitive to the body's need for sleep and catching up on any sleep with daytime naps and extra sleep at weekends, sleep can become a cooperative partner through life's challenges.

Obstructive Sleep Apnea vs. Central Sleep Apnea

Obstructive Sleep Apnea (OSA) is caused by obstructed breathing, either due to too much tissue as seen in obesity or decreased muscle tone which may be seen with low testosterone. This inhibits the air flow in the mouth and nose which causes snoring and decreased ability for adequate oxygenation during sleep. As a result, men often wake up numerous times during the night and rarely achieve deep sleep.

Central Sleep Apnea (CSA) is a central nervous system disorder in which the brain signal for breathing is delayed. CSA if often caused by injury or disease affecting the brain stem. Most cases of sleep apnea caused by low testosterone is obstructive sleep apnea.

Other Causes of Sleep Disorders

While hormonal deficiency is a common source of sleep disturbance during male menopause, there are other multiple causes, which may contribute, trigger, or escalate the sleep related problems. Let’s review them briefly.

Medical disorders

·         Physical pain is one of the most common reasons for poor sleep in aging people.

·         Heart failure often causes breathing problems that can disturb sleep.

·         Rapid heartbeat and palpitations can interrupt sleep.

·         Other breathing problems that can disturb sleep include heart disease, certain neurological problems, and emphysema.

·         A frequent need to urinate and other urinary problems may cause frequent awakenings.

·         Persons with Parkinson disease may experience frequent urination, difficulty turning in bed, and difficulty getting out of bed. These problems may impair sleep.

·         Gastroesophageal reflux disease (GERD) causes discomfort that can interfere with sleep.

·         Constipation can cause discomfort that can disturb sleep.

·         Allergies, sinus problems, nasal congestion, and similar problems can disrupt sleep.

·         Itchy skin conditions often cause sleep problems.

Mental disorders

·         Depression disrupts sleep in all ages, and this condition is especially common in older people. Many people with depression have trouble falling asleep at night or wake in the night and are unable to go back to sleep.

·         Dementia, especially Alzheimer disease, increases the length of stage 1 sleep and decreases stage 3, stage 4, and REM sleep. Dementia is linked to more episodes of sleep disruption and awakening, nocturnal wandering, and daytime napping.

·         Bipolar disorders, psychosis, and anxiety can result in difficulty falling asleep and/or staying asleep.

Medications

·         Sedative antidepressants and sedative antipsychotics can cause daytime drowsiness. Sleeping during the day interferes with nighttime sleep.

·         Beta-blocker medications can cause difficulty falling asleep, an increased number of awakenings, and vivid dreams.

·         Prolonged sleeping medication use may cause daytime drug withdrawal effects or daytime drowsiness.

·         Theophylline and caffeine are stimulant drugs. These drugs increase wakefulness and decrease total sleep time. Caffeine's effect can last as long as 8-14 hours and may be more pronounced in older patients. Over-the-counter pain relievers, cold or allergy remedies, appetite suppressants, and tonics may contain caffeine. 

·         The stimulant nicotine affects sleep like caffeine. Smokers have more sleep disturbances than nonsmokers. Smokers also have difficulty falling asleep and decreased sleep duration. Even a nicotine patch can disrupt sleep.

Lifestyle and social factors

·         Many older people are less active, and their bodies are not as ready for sleep at the end of the day.

·         Alcohol can disrupt sleep.

·         Daytime sleeping or lying on the bed to read or watch television can interfere with nighttime sleep.

·         Sadness and bereavement can interfere with sleep.

·         Everyday stress can make sleep more difficult.

Sources and Additional Information:

http://www.nlm.nih.gov/medlineplus/sleepdisorders.html

http://www.insomniacs.co.uk/menandsleep.html

http://www.emedicinehealth.com/sleep_disorders_and_aging/article_em.htm

http://www.bodylogicmd.com/for-men/sleep-apnea

http://insomniarevealed.com/insomania/

What Causes Mood Swings in Men?

The National Mental Health Information Center reports that mood swings are a form of mental disorder that affects millions of Americans each year. Although mood disorders can be a serious mental illness, they are treatable. Environmental factors and/or chemical imbalances in the brain may contribute to a person's mood swings. If left untreated, chronic mood swings can become debilitating.

Mood Swings at Andropause

There is a common knowledge that women get severe mood swings while at menopause, and the family members, friends and coworkers usually are able to accept these changes with understanding and patience. Until recently, men’s mood swings were not considered as character traits, which have any excuse to be tolerated. Now mood swings, commonly associated with female menopause, are now also being more accepted as a common side effect of male menopause as well. These symptoms that keep coming up time and time again are a natural part of the aging process, with men reporting a loss of drive at work and at play, feeling nothing is of use anymore and losing interest in hobbies and previous favorite past times.

The burn out, which can be physical and emotional, is backed by lack of motivation, enthusiasm and vitality experienced by andropausal men due to reduced hormone production during Andropause. Depression too, is a common complaint.

Many men feel emotional highs and lows during Andropause and these mood swings or ‘feeling down’ in certain cases can go beyond the occasional bouts of irritability and frustration to more severe problems like clinical depression, if not checked in time.

Doctors suggest that the loss of assertiveness and confidence due to bodily changes like increased body fat and decreased muscle tone, sleep problems and memory loss/difficulty in concentration that men go through during Andropause are symptoms that combine to cause mood swings.

The change in self image and perceived social image can cause andropausal men to feel uncertain about themselves and actual physical dysfunction may precipitate the mood swings as a loss of libido creeps up on patients- a touchy topic for all men needing to feel and be virile.

Mood Swings Symptoms

When men suffer from mood swings, they’re likely to display one or more of the symptoms listed below.

Unreasonable Censure

Men could consider their mood swings inexplicable but because of their nature, they will do their best to find a reason for it. Unless they’ve been properly diagnosed, they’re liable to blame others for their mood swings. Now, if there’s absolutely no other person to blame for their condition then men would usually resort to blaming themselves.

Anger and Irritability

Mood swings also make people more irritable and quicker to anger than usual. Mood swings are exhausting because it requires you to feel more than usual. One moment you’re happy, the next moment you’re down, and feeling like this several times a day certainly won’t make anyone feel good.

Creating and Avoiding Conflict

Mood swings make men feel unbalanced and unable to control their emotions. Because of this, they are more prone to create or avoid conflict, depending on the situation. If they feel they’re unable to cope with a problem then they’re likely to sweep it under the rug rather than face it head on. Then again, they can choose to alleviate their frustrations by creating conflicts instead.

Poor Sleeping Habits

Last but not the least, sleep is also affected by mood swings. Men could seek sleep excessively in order to avoid mood swings. On the other hand, men could also suffer from sleep deprivation because of mood swings.

Causes of Mood Swings

The most significant concern, or even crisis stage, for andropausal men is when they have to deal with unanticipated physical and psychological changes as knowledge about Andropause is very limited for the average male.

Mood swings in men are generally related to the hormonal misbalance during male menopause. Actually, it is caused by high levels of cortisol and low levels of testosterone in their organisms. Cortisol is a stress hormone and normal cortisol levels ensure that you are able to handle stress without letting stress affect our health. Medical experts explain that men are relatively poor in handling stress in daily life, comparing with women, and so high levels of cortisol hormone secretion in men causes harm to muscles and bones and increases fat content in the body. Excess cortisol also affects the functioning of testosterone in the body and this eventually results in increased body fat and difficulty in handling stress.  Due to the lack of bio-available testosterone during Andropause, men have lowered amounts in their blood. Therefore, tissues in the body that are stimulated by testosterone receive lower than normal doses and various physical and possibly mental changes occur - primary ones being mood swings or fatigue.

Testosterone is produced naturally and it is a very good mood stabilizer. However, the absence of it can cause several damages and also cause depression and anxiety. Even slightly low levels can actually trigger the mood swings and unpredictable behavior in affected men.

Mood Swings not related to Andropause

While this post primary deals with medical conditions, associated with male menopause, we would like to mention other possible causes of the mood swings, which require careful medical attention, as they may be just the symptoms of the severe medical illnesses.

Bipolar Disorder

The primary symptoms of the mania and depression associated with bipolar disorder include both behavioral and mood changes. People with bipolar disorder can experience long periods of manic and depressive episodes. Sometimes the episodes are so severe that they interfere with the individual's activities of daily living. According to the National Institute of Mental Health, although most individuals who have a family history of bipolar disorder do not develop the mental illness, they are four to six times more likely to suffer the disorder if they have a parent or sibling who has it. Men with bipolar disorder may also abuse alcohol or drugs and have relationship problems.

Diabetes

Maria Collazo-Clavell, M.D., an endocrinologist at Mayo Clinic, points out that extreme fluctuation in blood sugar levels can contribute to changes in mood, which people with diabetes may experience. Check your blood sugar level on a routine basis, but especially when you notice a mood change. Talk to your doctor if mood swings persist or occur often. Your medication may need to be adjusted.

Other causes

Mood swings can occur as a symptom of psychiatric disorders, besides bipolar disorder, we mentioned above, like borderline personality disorder, or they may result from a medical condition that directly affects the central nervous system, such as dementia, brain tumors, meningitis, and stroke. Mood swings can also result from conditions that deprive the brain of nutrients and oxygen, such as lung and cardiovascular diseases. Substance abuse and medication side effects are other potential causes of mood swings.

Treatment of Andropausal Mood Swings

If you feel that you have severe mood swings, that it is not like you, get alarmed to talk to your doctor. You may suspect that the reason is related to your andropause, but you need to be absolutely sure that your mood swings do not point to other than hormones fluctuation, medical condition. It may be easily treatable if you catch it early, and it may be deadly, if you catch it too late.

As far as you are confident that the mood swings are related to male menopause, follow the general recommendations on how to deal with this condition. However, most health experts agree that the mood swings andropausal men go through can also be largely affected by other symptoms like loss of fertility and decreased libido, sleep problems, hot flashes, increase in body weight and muscle loss. Diagnosing the causes and underlying conditions that are controllable can help treat mood swings and keep them at a minimum during Andropause - and stop you from turning the grumpy old man syndrome into a horrible reality for yourself and your loved ones.

Remember, if you got it, you are not along. Mood swings have been reported by many Andropause patients and in some cases they were reported in package with mild depression, say medical health experts working to raise awareness about male menopause at the national level. Unfortunately, there are no known studies to compare rates of depression in the pre-Andropause and post-Andropause stages in men, though the mood swings associated with changes in testosterone levels can be treated with testosterone implants readily available now.

Patients feeling low in spirits have been helped to alleviate mood swings through antidepressants but the best remedy still remains as open discussions and psychological counseling to bring back feelings of self- worth.

Good nutrition, health active lifestyle, comforting atmosphere at home, stress relieving techniques, and proper awareness of the causes and effects are the best ways to deal with the enemy. In many cases, you can win without medicines and hormone replacement therapy. However, if the conditions are severe, talk to your doctor on possibilities of applying the heavy medical artillery.

Sources and Additional Reading:

http://www.everythingandropause.com/articles/moodswings.php

http://www.livestrong.com/article/149404-what-causes-mood-swings-in-men/

http://www.elderlyjournal.com/menopause/mood-swings/Can-Low-Testerone-Cause-Mood-Swings.html

http://www.bettermedicine.com/article/mood-swings

http://mood-swings.bafree.net/symptoms-of-mood-swings-in-men.php

http://www.buzzle.com/articles/mood-swings-in-men.html

Weight Gain in Men during Andropause

Weight Gain in Men

While the cause and effect relationship is not absolutely clear, it is apparent that there is a strong connection between weight gain in men and andropause related hormonal imbalances. Low testosterone and high cortisol seem to increase body fat, especially in the midsection, and decrease muscle mass in men. This body fat seems to further the hormonal imbalance by converting testosterone into estrogen. Male weight gain coupled with muscle loss means more weight to carry and less muscle to carry it with, resulting in fatigue and low energy levels.

Specific Hormonal Causes of Male Weight Gain

Weight gain in men is affected by high stress or cortisol levels in the body. Prolonged heightened levels of cortisol put the body into survival mode and induce the production of fat cells and the decline of metabolism to store food for later use. The cortisol also increases appetite in order to procure energy for ‘fight or flight.’ Male weight gain naturally follows.

High cortisol levels further diminish levels of testosterone, which already suffer during andropause. Low testosterone can cause low energy and fatigue, meaning less physical activity and weight gain in men. Thyroid disorders, particularly hypothyroidism, and low levels of the human growth hormone (HGH) often cause weight gain by way of decreasing the body’s metabolic rate.

Weight Gain and Mid-Life Crisis

In most people, the hormonal changes during andropause might be accompanied by the emotional transitions, associated with midlife crisis. A high degree of stress during this time in your life can lead to emotional eating and an overconsumption of calories, causing weight gain. Children growing up and leaving the home, a change in career, dealing with an aging body or disappointment in not having realized lifelong dreams could be possible reasons for feeling sad or frustrated during midlife.

For some people who suffer from a midlife crisis, motivation may be at an all-time low. Feelings of regret, loneliness or hopelessness may lead to depression. When people are depressed, binging and emotional eating are ways to find temporary relief from feelings of sadness or melancholy.

3M Technique for Fighting Weight Gain

If you would like to keep your weight under control in spite of the hormonal and emotional complications during andropause, or at the very least minimize its impact, there are just three 3Ms you should be aware of - mind, muscle and mouth. If you want to keep a healthy weight then the thing you should do is avoid stress at all times, and positive thinking does the trick in this case. Get yourself to ditch negative thoughts, and losing the pounds should become easier. It is easy to say “Be positive”. It is more complicated to actually be positive no matter what, overcoming negative health and life time changes, characterizing this period. While our society is overall negative about ageing, that doesn't mean you have to be. Middle age is a time of great change, and that can mean beneficial changes too. You have a chance to review your life so far and to alter its direction in a positive way. A crisis can be used as an opportunity to change your life for the better.

One other thing is you should be careful with what you put in your mouth. Watching what you eat is very important now that you are not exactly young anymore. Comfort foods which at one time did provide you with “comfort” are the very foods that can cause many discomforts in your life. Now that you are forty or beyond, it’s time to be wiser and to be more aware of the foods that you are eating. Quality means that you have to take foods that are rich in nutrients and those that are found to be very beneficial to your body such as fruits, vegetables, whole grains and lean proteins like fish and lean meats.

The third “M” which stands for Muscle would refer to exercise programs and weight training that serve to build muscles. Get your doctor’s advice first, though, especially if you are not in the peak of health to begin with. If your doctor clears you, then wait no longer; go ahead and exercise. Just always remember to take things slowly and gradually. Don’t push yourself too hard. By finishing off with exercises, you are sure to keep those pounds off. It's easy just to slob out, especially when you're feeling lethargic and down, but keeping fit will help to relieve stress and mild depression, and work out feelings of frustration. For all-round benefits, try to combine aerobic exercise, such as running, cycling or swimming, with some resistance work, such as weight training. It's vital to get into a routine that you won't find difficult to stick to. Playing a team sport and/or joining a club is a powerful motivator, as you won't want to let the lads down. It may well allow you to meet other men beyond the familiar circles of work and family, which can be refreshing and even therapeutic; chances are, others will be experiencing similar problems.

Healthy Diet

Knowledge of basic nutrition will help you to make the right choices about the sort of food you eat. A balanced diet contains:

• Some protein such as lean meats, fish, chicken, turkey, eggs, soy foods, pulses.
• Some carbohydrates such as pasta, rice, bread, potatoes
• Some fats such as oil, nuts and seeds
• Some fruits and vegetables.

If you have a healthy balanced diet you should not need to take any extra vitamins or minerals in tablet form. Build some indulgences into your plan. You want a lifestyle diet that works so you need a few sins too.

• Only eat when you are hungry. Never eat unless you are hungry. Eating simply out of habit or boredom will not help you to slim. Don't sit around the table shooting the breeze (and having an extra beer, and eating the rest of what's on your plate). Push away from the table when you're full.
• Make smart fast-food choices. Eat a salad, easy on the dressing. Choose grilled chicken or a small, plain burger instead of a Whopper or Quarter Pounder.
• Cook at home, where you can control the amount and type of fat and other nutrients. That's what the Food Network is for. Notice all the men cooking.
• Remember, there will be rewards even if you reduce your weight by just 10%: You'll lower health risks, enjoy shooting hoops with the kids, improve your performance in the bedroom, look better, and have more energy.
• Don't beat yourself over the head if things go wrong; just re-focus and press on.

Sources and Additional Information:

http://www.bodylogicmd.com/for-men/weight-gain

http://www.3fatchicks.com/is-your-midlife-crisis-causing-you-to-gain-weight/

http://factoidz.com/midlife-crisis-and-weight-gain-the-3ms-to-avoid-midlife-weight-gain/

http://www.rightsandwrongs.co.uk/men/76-general/7148-men-mid-life-crisis

http://www.medicinenet.com/script/main/art.asp?articlekey=56860&page=2

Fatigue in Men during Andropause

One of the symptoms of male menopause most prominently described by patients is their perception of suffering from fatigue.

Fatigue in Men

Fatigue in men is usually described as a total lack of energy, both physical and emotional. It is perceived as feeling of struggling to get through the next activity or the cumulative activities of the day. The energy of youth becomes a distant memory. Fatigue is usually a combination of depression, a decrease in metabolism and adrenal fatigue as a result of excess stress– all are caused by hormone decline, primarily testosterone, thyroid and cortisol. There are other contributing factors such as trouble sleeping, weight gain, loss of muscle – all have a cause based in hormonal decline.

Men often experience a waning capability for work or every day activities and overall reduced efficiency and sense of achievement.

What Causes Fatigue in Men?

Testosterone plays an important role in energy production. During andropause, diminished testosterone levels are a major cause behind insomnia or sleep apnea, both of which contribute to fatigue in men. In addition to diminished testosterone, interruption of sleep in men can be caused by symptoms such as night sweats, depression, irritability, weight gain and stress.

Night sweats in men with fatigue add to insomnia and fatigue because they make it difficult to get a good night’s rest. Having to get up in the middle of the night over a period of time can lead to sleep deprivation and ultimately fatigue. Irritability and depression, two very frequent symptoms of andropause can be very draining emotionally, causing feelings of weariness and exhaustion.

Additional weight gain and loss of muscle mass can leave men feeling sluggish and tired. Stress and high cortisol can leave men feeling overwhelmed and frustrated which clearly affects energy levels. Eating the wrong foods can also leave little energy for the body. While exercise itself is tiring, men with fatigue often feel an energy boost after a workout. Not enough exercise can make fatigue in men worse.

Procrastination becomes a bigger player — “I don’t feel like doing it, maybe tomorrow”. Depression becomes a particularly important issue in its negative effect on physical activity and exercise. The motivation to get out and DO IT is just not there. There is a cause and effect relationship between depression and physical activity/exercise – (more depression = less activity and less activity = more depression).

Dr. Alan Mintz, from the Cenegenics Medical Institute in Los Vegas, explains that this symptom can "include loss of strength (if left untreated, this can lead to gradual muscle atrophy); loss of energy (getting tired early in the evening, falling asleep in front of the TV); stiffness and aching of muscles and joints." Most experts agree that chronic fatigue is a primary symptom of having diminished sex hormone levels.

What to Do?

All andropause symptoms are kind of linked together and can be traced to the hormonal imbalance. We will review the medical, alternative, and lifestyle related ways to form a successful resisting shield, helping to slow down the gradual changes in our body and mind. In relation to fatigue in particular, you need to give yourself more rest and treat your physical and emotional well-being with great respect. Keep yourself focused on your essential tasks, but give yourself enough sleep to get recharged. Spent some time exclusively for yourself – not for your spouse, your kids, friends, or parents. You deserve it!

Listen watchfully for your body and act promptly when problem signs appear, but do not be a slave of your body. Move, go out, and enjoy your life!

Misdiagnosis

While fatigue is one of the markers of the normal andropause, you should be aware that there is a medical condition, which might have a similar appearance, but might not be associated with particular age. It is Chronic Fatigue Syndrome (CFS).

Chronic Fatigue Syndrome (CFS) is an illness of unknown origin whose primary symptom is of extreme fatigue and flu-like symptoms.

Yes, in spite of the rapid development of the medical science, researchers still are not quite sure what causes chronic fatigue syndrome. There are some who favor viral causes from several different possible viruses including herpes simplex, the virus that commonly causes cold sores. Epstein-Barr, the virus that causes mononucleosis is another possible cause.

There are others who think that CFS is an autoimmune disorder, as seen in lupus, or allergic individuals, or rheumatoid arthritis, where the immune system ramps up into high gear to fight invading organisms and winds up attacking itself instead!

Still other researchers feel CFS may be caused by other physical conditions, such as mercury dental fillings, low thyroid, low blood sugar, insomnia, or even a nutritional deficiency! Whatever the various possible causes, there seems to be an association between CFS and stress which may trigger the condition.

As published in the ANNALS OF INTERNAL MEDICINE in 1988, the Centers for Disease Control has developed a case definition for Chronic Fatigue Syndrome which includes:

I. New onset of persistent or relapsing fatigue, with at least 50% reduction of activity level for at least 6 months.

II. Exclusion of other conditions through History, Physical examination and Laboratory Examination.

III. 6 of the following 11 symptoms:

1. Mild fever
2. Sore throat
3. Painful lymph nodes
4. Muscle weakness
5. Muscle pain
6. Prolonged fatigue after exercise
7. Headaches
8. Joint pain
9. Neuropsychologic complaints
10. Sleep disturbance
11. Acute onset of symptoms

And 2 of 3 signs on physical examination:

1. Low grade fever
2. Throat inflammation
3. Palpable or tender lymph nodes

IV. OR 8 of the 11 symptoms without physical signs.

While societal expectations are indeed changing, it has long been perceived that the male has unique and different responsibilities, within the family, than does the female member. For many, a male may base his self-worth on his ability to perform, to succeed and to provide for the family. Being afflicted with CFS, the male cannot meet such self-imposed and societal expectations. In many cases, it is not uncommon for the individual to attempt to push or fight to keep himself functioning at his pre-illness level. The goal of such behaviors may be to escape from the feelings of being a failure and of "letting others down."

However, pushing oneself beyond the physical limits will typically result in a relapse of the condition thus only placing the individual deeper and deeper into the hole of recovery and a never ending vicious cycle begins.

Staring at an illness which impedes or blocks the ability to perform at even a minimal degree of the pre-illness capacity makes this task even more difficult. It is essential that all individuals with CFS, and especially males, must confront their own expectations of themselves. The individual must question if such are truly realistic and accept their individual strengths and limitations. Having such an illness does not render the male "less masculine" or lower his value to the family or society. It is imperative that each individual must develop the mindset of setting realistic goals within the individual's PRESENT abilities and to stick with such regardless of the pressure which might be received.

Males have far too often attributed self-worth with their income potential or employment position. As the illness encompasses the individual's life, the capacity to be gainfully employed and to use the energy to "climb the corporate ladder" becomes an even greater and burdensome task. Many will see themselves gradually falling behind their peers up the ladder of success. They may hear of others successes which further deepens the undercurrent of their own present shortcomings. Furthermore, as they are unable to perform the tasks within the workforce, the likelihood of receiving supplemental income through disability can become even more possible.

Dating back to the Stone Age, males were taught to hunt, feed and protect the family from all outside predators. However, what if the "predator" is an illness from within which renders the protector unable to perform those duties? Males are often taught, at a very young age, that others will have certain expectations from and for them, roles to perform and they are to never relinquish such regardless. The family may be forced to make dramatic changes. Often times, males feel powerless to stop the negative changes, let alone view themselves as the cause of such. The "demons" in their own head may begin to surface as well as fearing others perceptions as the effects of the illness begins to take its toll. "Old lessons" must be rewritten or discarded. New lessons of each individual pulling a "fair share" must emerge. Change need not necessarily be negative. One must remember that no matter what happens, others will continue to think whatever they are going to think. Facing and confronting others expectations is a task which everyone, with or without CFS, must undertake.

As with the females affected by CFS, many individuals can experience some change in weight as they no longer possess the energy to engage in physical activities or exercise. The loss of their physique is often times extremely difficult to face. Many such individuals may fear rejection by their loved one due to their perceived "non-attractiveness." In such cases, open communication with the loved one is often recommended.

For the most part, in spite of recent movements, the societal view that males should not express or verbalize their fears and feelings continues to exist. It is almost as if many males fear becoming "weak" to express their feelings, fears and disappointments. It is well known that fewer males tend to seek counseling or attend area support groups. Hopefully, as our society continues to change, males will allow themselves this avenue of assistance. It is only through the verbalization of the fears and feelings that any individual can face and overcome them. Without such, the feelings and fears tend to grow and grow within their own being.

An individual's ability to be "productive" in life has far too long been correlated with self-worth. The basis for this standard of "productivity" is generally based upon the individual's pre-illness capacity or level of functioning. For all individuals getting older in years, this is an unrealistic standard as we all lose abilities with age. Such is especially true for those afflicted with CFS. When the individual attempts to continue judging their life by this unrealistic standard, secondary depression will develop.

For all, and especially males, afflicted with Chronic Fatigue Syndrome, the following suggestions should be considered:

1. Do not attempt to push yourself beyond your present physical capacities. Accept and work within your present realm of abilities.
2. Set immediate, realistic and obtainable short-term goals which can be achieved on a daily basis.
3. Talk, talk, talk. Express your feelings and fears -- not for the purpose of having others refute your beliefs, but rather to assist you in seeing yourself in a more realistic perspective.
4. Attend area support group meetings. Attend or develop a support group specifically designed to address the unique issues directly related to males afflicted with CFS.
5. Throw out "old lessons" of roles which a male should or must meet in order to be of any value. Write "new lessons" for your individual life.
6. Realize that change does not necessarily produce negative results or consequences. Look for the gains which can be achieved by and through the changes.
7. Accept that you may not be as powerless as you feel or fear. While you may not have power over your own physical abilities now, or how others may perceive you, you always have absolute power and control over how you view yourself.

Lifestyle Tips to Boost your Energy

Getting back to our first suggestion, do not try to push over the limits or self-medicate with one of these energy boosters, available on the open market. Listen your body and help it to recognize the health troubles early, when they can be managed the most efficient and painless way.

Still, there are several suggestions for the lifestyle changes, which may help to fight your testosterone deficiency, which is coming with the aging, no matter what.

1. Develop strategies to combat sedentary living. One of the main reasons that older people feel weak is that they slip into a sedentary lifestyle or allow themselves to be trapped by boredom. But there are some easily applied antidotes to these enemies of high-energy living. With inadequate physical activity, muscles begin to lose strength, and they tend to feel weaker and weaker. Exercise is one of the best available strategies to counter this decline in muscle strength and endurance. Many times, extra exercise is exactly what is needed. You can embark at any age on a program to build up your muscles and increase your aerobic lung capacity. The more exercise you do, the more likely you are to increase the energy and enthusiasm in your life.

2. Learn creative ways to combat boredom. Another common cause of weakness and fatigue in older people is boredom. Many of the people who have these complaints are retired, and lack a regular daily schedule or activities to keep them interested and involved in life. As a result, they begin to feel useless and may start suffering from depression. A chronic sense of weakness or fatigue is a natural consequence of this process. Compulsory and unwilling retirement is one of the greatest geriatric threats to our society. For many people, stopping work sets the stage for diminishing brain stimulation and loss of muscle strength. The best cure for such people is to have a part-time job of some sort. You should work a few hours each day, just to keep your mind and body active. If you do this your feelings of fatigue will disappear.

3. Get more sunlight. Yes, we need sunlight. Often retired people do not go outside for days at a time. Open the blinds and let the light in, even if it is raining! There is a benefit to daylight in your life every day. Go outside for a short walk each day if you possibly can. Sunlight gives us vitamin D which is good for our eyesight and our skin responds by darkening just a little to protect us. Do not overexpose yourself to sunlight, however. Skin cancer is not what you have dreamt on.

4. Drink enough water daily. Are you drinking enough water? It's easy to become partly dehydrated and this state will influence your energy levels. Feeling thirsty can sometimes be mistaken for food hunger or tiredness. Take a big drink of water and see if you feel better. If you pay attention, you might find that you brighten right up.

5. Eat healthier. Food is a huge part of our life support system. Do you find yourself craving sweets? Sugar can give you a rush but leave you feeling tired. Any type of fruit is better for you. Try hard to stay away from sweetened cereals and then try honey instead of sugar. Eating the right combinations of foods makes a difference in your energy too. Your body needs fiber. We used to call it "roughage" and it is found in fruits and vegetables. Some doctors recommend five servings of fruits and vegetables every day for older people.

6. Have enough sleep. Are you sleeping well? Need naps? You can get sleep deprived pretty quickly and you might need to learn some tricks for going to sleep and staying that way. A little exercise during the day, cutting back on sugars and alcohol at bedtime, and a well-balanced food plan can really help your sleep. Even if you need to get up in the night to go to the bathroom, you will go back to sleep more quickly if you are taking care of your body.

7. Learn to relax. There are many techniques, especially with complementary and natural therapies that can help you to relax and revitalize your energy. Developing personal relationships with friends and relatives can be helpful. Also, making time for gratifying activities and having fun is a great way to get over tiredness.

8. Listen your body clock. Some people get a burst of energy first thing in the morning. They're often called morning larks. Night owls are people who are at their best at the end of the day. These individual differences in daily energy patterns are determined genetically and can be tough to change. Instead, become aware of your own circadian rhythms. Then schedule demanding activities when your energy levels are typically at their peak.

9. Talk about it. There’s some evidence that talking therapies such as counseling or cognitive behavioral therapy (CBT) might substantially help to fight fatigue. See your therapist who will help you to shape strategy to combat your fatigue.

Sources and Additional Information:

http://www.renewman.com/fatigue-in-men/

http://www.bodylogicmd.com/for-men/fatigue

http://www.selfgrowth.com/articles/chronic_fatigue_syndrome_in_men

http://www.prohealth.com/library/showarticle.cfm?libid=8114

http://webspace.webring.com/people/fc/cfsdays/cfs-men.htm

Male Menopause (Andropause) Symptoms

Male Menopause symptoms are established when the male is diagnosed with andropause—the male equivalent of menopause found in females. This refers to a condition during which the testosterone levels decline appreciably in men. Since, testosterone is the primary sex hormone in males along with being a secondary metabolic hormone; Male Menopause induces a wide variety of symptoms. Among these, decreased muscular strength and declining libido are the chief indications while infertility is also possible. It should be noted that males tend to have greater amounts of testosterone and undergo a far more severe decline in testosterone as they age, when compared with females who also suffer an age-based hormonal decline. This decline in testosterone levels is natural since after peaking around the age of 18, most men suffer from declining synthesis of testosterone.

A slight (and gradual) decline in the hormone levels is not referred to as male menopause. This condition is indicated when the testosterone levels are so low that it becomes a direct deterrent to the patient’s overall well-being, particularly their sexual and reproductive health. Natural male menopause is accepted to be established after the age of 50 whereas male menopause sets-in much earlier, usually during the middle-age years.

Causes of Sudden Onset of Male Menopause

Male menopause is often triggered in an acute and sudden fashion. This is caused by factors such as acute illness like tuberculosis or liver damage. Other causes include physical trauma suffered in an accident. It has now been established that male andropause is often fastened due to the illnesses that affect the lungs such as pneumonia. Similarly, cardiac patients show a greater potency towards developing male menopause much earlier than the usual age. However, men suffering from autoimmune diseases and cancer seem to present a much higher risk of developing low testosterone levels prematurely.

Symptoms of Male Menopause

Physical

• Less endurance for physical activity.
• Fatigue, lessening energy.
• Muscle loss.
• Gain in weight.
• Bones deterioration.
• Loss or thinning of hair.
• Sleep disturbance.
• Night sweats.
• Urinary problems.
• Hot flashes.
• Gynecomastia (enlarged breasts).

Psychological

• Irritability.
• Mood Swings.
• Indecisiveness.
• Anxiety and fear.
• Depression.
• Declining self-confidence.
• Feeling lonely, unattractive and unloved.
• Forgetfulness and difficulty concentrating.

Sexual

• Reduced interest in sex.
• Erectile dysfunction.
• Increased anxiety and fear about losing sexual potency.
• Increased fantasies about having sex with a new and younger partner.
• More relationship problems and fights over sex, love and intimacy.

Sources and Additional Information:

http://lowtestosteronesymptoms.org/male-menopause-symptoms/

http://www.drlera.com/male_symptoms.htm

http://www.safemenopausesolutions.com/male-menopause.html

http://www.bodylogicmd.com/for-men/symptoms-of-andropause

http://www.healthguidance.org/entry/4786/1/Male-Menopause-Symptoms.html

Official Recognition of the Male Menopause Concept

The concept of the Andropause (Male Menopause) is still considered controversial, but the latest research has finally officially identified the symptoms associated with a reduction in testosterone in older men. This finding is accompanied with disclaimer that unlike the female menopause, which affects all women, the male menopause is relatively rare, affecting only 2% of elderly men, and is often linked to poor general health and obesity.

The link between the decline in testosterone levels seen in older men and late-onset hypogonadism (also known as male menopause) has long been a subject of debate. Now, for the first time, investigators have identified the symptoms of this condition and published their findings in the New England Journal of Medicine.

To establish the list of symptoms, the University of Manchester researchers, working with colleagues at Imperial College London, UCL (University College London) and other European partners, led by Dr. Fred Wu, a professor at The University of Manchester’s School of Biomedicine, surveyed a sample of 3,369 men aged 40 to 79 from eight different European centers. All the participants answered questions related to their general, sexual, psychological, and physical health.

Blood samples were collected from the men to determine their free and total testosterone levels. Free testosterone is the amount of the hormone present in the bloodstream that is not bound to protein. It comprises 2 percent of the testosterone in the body and is the biologically active form of the hormone. Total testosterone is the amount of both bound (and biologically inactive) and unbound testosterone.

The researchers selected three sexual, three physical, and three psychological symptoms they believe to be significantly linked with low testosterone levels. The three strongest indicators of male menopause were found to be in the sexual category: decreased frequency of morning erections, erectile dysfunction, and a decreased frequency of sexual thoughts. The lower a man’s testosterone levels, the more sexual symptoms he had.

The remaining six symptoms were only weakly linked to low levels of testosterone: loss of energy, sadness, fatigue, an inability to walk more than 1 km, an inability to participate in vigorous activity, and an inability to stoop, bend, or kneel. Overall, Dr. Wu noted that male menopause is often associated with poor overall health and obesity.

The results of the new study have established that the definition of late-onset hypogonadism, or male menopause, is “the presence of at least three sexual symptoms associated with a total testosterone level of less than 11 nmol per liter (3.2 ng per milliliter) and a free testosterone level of less than 220 pmol per liter (64 pg per milliliter).”

Dr. Wu and his colleagues also ruled out certain symptoms that have been linked with male menopause in the past, but which did not show any significant link with low testosterone levels, including poor concentration, anxiety, nervousness, changes in sleep habits, feelings of worthlessness, and trouble getting out of a chair.

One reason for the interest in this condition is the 400 percent increase in the United States in the practice of prescribing testosterone therapy. However, Dr. Wu explained that this hormone treatment “may only be useful in a relatively small number of cases where androgen deficiency is suspected,” because they found that many of the symptoms of hypogonadism were not associated with low levels of testosterone in older males.

The research, part of the European Union-funded European Male Ageing Study, also identified the thresholds of testosterone below which certain symptoms become increasingly prevalent. Documentation of levels of testosterone below these thresholds is required to confirm the diagnosis of hypogonadism in symptomatic elderly men.

However, even with the nine rigorously selected symptoms, differences in testosterone levels between symptomatic and non-symptomatic men were marginal, highlighting the weak overall association between symptoms and testosterone levels.

Professor Wu added: “The long list of nonspecific symptoms that have a potential association with testosterone deficiency makes it difficult to establish a clear diagnosis of late-onset hypogonadism. This situation is further complicated when you consider that even the most specific sexual symptoms of androgen deficiency was relatively common among men with normal testosterone levels.

“It is therefore important to specify the presence of all three sexual symptoms of the nine testosterone-related symptoms we identified, together with low testosterone, in order to increase the probability of correctly diagnosing late-onset hypogonadism. The application of these new criteria should guard against the excessive diagnosis of hypogonadism and curb the unwise use of testosterone therapy in older men.”

Sources and Additional Information:

http://www.emaxhealth.com/1275/male-menopause-symptoms-officially-identified

http://www.manchester.ac.uk/aboutus/news/display/?id=5854

http://men.webmd.com/news/20100617/male-menopause-the-signs-symptoms