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Male menopause: Myth or reality?

Sometimes called male menopause, aging-related hormone changes are very different in men than in women. Learn about symptoms and treatment.

By Mayo Clinic staff Less interested in sex lately? Tired? Grumpier than usual? Is this a midlife crisis brewing? Or are you feeling the normal hormone changes associated with aging? Hormone changes are a natural part of aging for men. But male menopause is not an accurate description. Unlike the more dramatic hormone plunge that occurs in women during menopause, hormone changes in men occur gradually, over a period of many years, the effects of which are often subtle and not noticed until much later in life. Some men are never affected by lower hormone levels at all — while some have physical and psychological symptoms that can include changes in sexual function, energy levels or mood. While the term "male menopause" is sometimes used to describe decreasing testosterone levels related to aging, Todd Nippoldt, M.D., an endocrinologist at Mayo Clinic, Rochester, Minn., prefers the term "andropause." "There needs to be a distinction because we're dealing with two different situations," he says. "In women, ovulation ceases and female hormone production plummets over a relatively short time frame. In men, there's a gradual decline in the production of male hormones." Age-related decline in testosterone levels are also called testosterone deficiency, androgen decline in the aging male (ADAM) or late onset hypogonadism (LOH).

Male hormones over time

In general, older men have lower testosterone levels than do younger men. After age 40, testosterone levels in the blood begin to decline gradually — at a rate of about 1 percent a year. While there's a steep drop between the ages of 45 and 50, reduction in testosterone levels are rarely significant enough to be noticeable in men younger than 60. By the time men reach their 80s, about half have low testosterone. But testosterone levels vary greatly among men — and some men maintain normal testosterone levels into old age. Other men who have low testosterone levels don't have bothersome signs or symptoms.

What are the symptoms of andropause?

Lower than normal testosterone levels do not cause symptoms in all men — and signs and symptoms of low testosterone vary from person to person. Some of these signs and symptoms are a normal part of aging. The only sure way to know whether you have low testosterone levels is through blood tests. Signs and symptoms of low testosterone can include:

• Reduced sexual desire
• Infertility
• A decrease in spontaneous erections (such as during sleep)
• Swollen or tender breasts (gynecomastia)
• Loss of body and pubic hair
• Small or shrinking testes
• Height loss and thinning bones
• Reduced muscle bulk and strength
• Hot flushes and sweats

Other signs and symptoms can include:

• Decreased energy, motivation and self-confidence
• Feeling sad or depressed
• Poor concentration and memory
• Sleep apnea or other sleep problems
• A low red blood cell count (mild anemia)
• Increased body fat
• Diminished physical or work performance

Testosterone replacement therapy

Treatment of low testosterone due to aging with testosterone replacement therapy (TRT) is controversial. The benefits of TRT are not clear, and it may increase the risk of prostate cancer. While certain men who have symptoms related to abnormally low testosterone may benefit from testosterone replacement therapy, it isn't appropriate treatment for most aging men. While it has been shown to help some men with low testosterone, TRT has risks, especially for men with certain health conditions such as prostate cancer and heart disease — and it may not improve your symptoms. More studies need to be done to determine the effectiveness and safety of TRT in aging men, and who can benefit most from this type of treatment. As it turned out with hormone replacement for women, TRT may have possible long-term risks that are not yet known.

Herbal supplements: Do they work?

Although many herbal supplements are widely marketed with the claim that they can relieve symptoms, none has been proved safe and effective for aging-related low testosterone. One of the most common supplements marketed to treat this condition, DHEA, may increase the risk of prostate cancer. More studies are needed to evaluate possible health benefits — and dangers — of taking DHEA or other supplements. Talk with your doctor before taking any herbal supplements, as some can cause side effects or cause problems with medications.

Is it low testosterone — or is it something else?

Symptoms caused by testosterone deficiency are similar to symptoms caused by other things. Signs and symptoms can include:

• A number of other health problems such as liver disease, kidney failure, or an overactive or underactive thyroid
• Side effects of medications
• Lifestyle choices such as excessive alcohol use or use of illegal drugs
• Psychological conditions, such as depression or emotional distress related to life changes that come with middle age (the so-called midlife crisis)

Steps that may help

While there's no way to avoid lower testosterone levels caused by aging, there are a few things you can do to help prevent or improve symptoms caused by the condition:

• Eat right and stay active. Regular exercise and a healthy diet can help you maintain your strength, energy and lean muscle mass. It can also improve your mood and help you stay sharp as you get older.
• Talk to your doctor about sexual problems. Erectile dysfunction and other sexual issues are common as men get older. Your doctor can help you find the best way to cope. Medical treatment, lifestyle changes or changes to the dose or types of medications you take may help.
• Seek help if you feel down. Many older men suffer from depression. It often goes undiagnosed — but treatment can make a big difference in how you feel. Depression in men doesn't always mean having the blues. You may have depression if you feel irritable, isolated and withdrawn. Other signs of depression common in men include working all the time, drinking too much alcohol, using street drugs or seeking thrills from risky activities.

If you are an older man and you have bothersome symptoms you think might be caused by low testosterone, see your doctor to get a firm diagnosis and find out your treatment options. While low testosterone does cause signs and symptoms in some men, your symptoms may be caused by normal aging or something else. Identifying and treating other health issues that can cause or worsen symptoms, making lifestyle changes, or changing the type or dose of medications you take may be enough.

Belly fat in men: Why weight loss matters

Belly fat is unhealthy. Find out what causes belly fat, the health risks it poses for men and what you can do to lose the extra pounds.

By Mayo Clinic staff If you're carrying a few extra pounds, you're not alone. But this is one case where following the crowd isn't a good idea. Carrying extra weight — especially belly fat — can be risky. Michael Jensen, M.D., an endocrinology specialist at Mayo Clinic, Rochester, Minn., answers common questions about belly fat in men.

Why is belly fat a concern for men?

People who gain belly fat are at greater risk of serious health problems than are people who accumulate fat in other areas — and men are more likely than women to gain weight around the waist. Having a large amount of belly fat increases your risk of:

• Heart disease
• Stroke
• Some types of cancer
• Type 2 diabetes
• Insulin resistance
• High triglycerides
• Low levels of high-density lipoprotein (HDL), or "good," cholesterol
• Metabolic syndrome
• Sleep apnea

How can you tell if you have too much belly fat?

Your waist size is a good indicator of whether you have too much belly fat. Although measurements that compare your hip and waist circumference (waist-to-hip ratio) or compare your height and weight (body mass index) are more precise, your waist size alone can give you a good estimate. For most men, the risk factors for heart disease and other diseases increase with a waist size greater than 40 inches (102 centimeters). To measure your waist:

• Place a tape measure around your bare abdomen just above your hipbone.
• Pull the tape measure until it fits snugly around you but doesn't push into your skin.
• Make sure the tape measure is level all the way around.
• Relax, exhale and measure your waist — no sucking in your belly!

Does age play a role in gaining belly fat?

As you age, you lose muscle — especially if you're not physically active. Muscle loss can slow the rate at which your body burns calories. In turn, if you don't limit your calories or increase your physical activity, you may gain weight.

Is belly fat inherited?

Your genes can affect your chances of being overweight or obese, as well as where you carry extra fat on your body. For most men, however, the problem likely has more to do with lifestyle than inherited traits.

Can you really get a beer belly from drinking?

Drinking excess alcohol can cause you to gain belly fat — the "beer belly." However, beer alone isn't to blame. Drinking too much alcohol of any kind can increase belly fat, although some research suggests wine may be an exception. If you drink alcohol, do so in moderation. Limiting yourself to two drinks a day will reduce the amount of calories you consume and help you avoid gaining belly fat. It's also better for your overall health.

How do you get rid of belly fat?

Whether you're trying to lose belly fat or trim fat from another part of your body, weight-loss basics remain the same:

• Reduce calories. Reduce your portion sizes. Replace your usual fare with healthy foods that contain fewer calories.
• Increase physical activity. The Department of Health and Human Services recommends adults get two hours and 30 minutes a week of moderate aerobic activity or one hour and 15 minutes of vigorous aerobic activity, in addition to strength training. You may need to do more to lose weight and keep it off.

After you shed excess pounds, maintain your weight loss with a healthy diet and regular physical activity.

Can you reduce belly fat with sit-ups?

Sit-ups help make your abdominal muscles stronger, but spot exercises alone won't specifically reduce belly fat. The best way to shrink your waist size is to lower your total body fat through healthy eating and exercise.

The bottom line

If you have a spare tire, don't despair. You can lose belly fat — it just takes patience and effort. In fact, shedding even a few extra pounds can help you feel better and lower your risk of health problems.

El cáncer de la próstata es una enfermedad en la cual se forman células malignas (cancerosas) en los tejidos de la próstata. La próstata es una glándula que pertenece al sistema reproductor masculino localizada justo debajo de la vejiga (el órgano que recoge y desecha la orina) y delante del recto (la parte inferior del intestino). Su tamaño es como el de una nuez y rodea una parte de la uretra (el tubo que conduce la orina al exterior desde la vejiga). La glándula prostática produce un fluido forma parte del semen.

Ampliar

Anatomía del sistema reproductor y el sistema urinario masculino, muestra la próstata, los testículos, la vejiga y otros órganos.

  El cáncer de la próstata se encuentra principalmente en varones de edad avanzada. A medida que los hombres envejecen, la próstata puede agrandarse y bloquear la uretra o la vejiga. Esto puede ocasionar dificultad para orinar o interferir con la función sexual. El problema se conoce con el nombre de hiperplasia prostática benigna y si bien no se trata de un cáncer, es posible que se necesite la cirugía para corregirlo. Los síntomas de la hiperplasia prostática benigna o de otros problemas que afectan la glándula pueden ser similares a los síntomas del cáncer de la próstata.

Ampliar

Próstata normal e hiperplasia prostática benigna (HPB). Una próstata normal no obstruye el flujo de la orina desde la vejiga. El agrandamiento de la próstata ejerce presión sobre la vejiga y la uretra, y obstruye el flujo de la orina.

  Algunos de los posibles signos del cáncer de la próstata comprenden una disminución del calibre del chorro urinario o aumento de la frecuencia de la micción (expulsión de la orina). Estos y otros síntomas pueden ser ocasionados por el cáncer de la próstata. Existe la posibilidad de que otras enfermedades ocasionen los mismos síntomas. Se debe consultar con el médico en caso de que se presente cualquiera de los siguientes problemas:

• Disminución del calibre o interrupción del chorro urinario.
• Aumento de la frecuencia de la micción (especialmente por la noche).
• Dificultad para orinar.
• Dolor o ardor durante la micción (expulsión de la orina).
• Presencia de sangre en la orina o en el semen.
• Dolor en la espalda, las caderas o la pelvis que no desaparece.
• Dolor con la eyaculación.

Para detectar (encontrar) y diagnosticar el cáncer de la próstata se utilizan pruebas que examinan la próstata y la sangre. Entre las pruebas y procedimientos que se pueden utilizar se encuentran los siguientes:

• Examen digital del recto (EDR): consiste en un examen del recto mediante el cual. El médico o la enfermera inserta un dedo dentro de un guante lubricado en el recto y palpa la próstata a través de la pared rectal en busca de nódulos o áreas anormales.

  Ampliar

  -

  Examen rectal digital (ERD). El médico inserta un dedo dentro de un guante lubricado en el recto y palpa la próstata para determinar si existe alguna anomalía.

• Antígeno prostático específico (APE): prueba de laboratorio que mide las concentraciones del APE en la sangre. El APE es una sustancia producida mayormente por la próstata que se puede encontrar en mayor cantidad en la sangre de los hombres que tienen cáncer de la próstata. La concentración de APE también puede ser elevada en los hombres que sufren una infección o una inflamación de la próstata, o que tienen una hiperplasia prostática benigna (HPB; aumento de tamaño de la próstata de origen no canceroso).
• Ecografía transrectal: procedimiento por el cual se inserta en el recto una sonda que tiene aproximadamente el tamaño de un dedo para examinar la próstata. La sonda se utiliza para hacer rebotar ondas de sonido de alta energía contra los tejidos internos de la próstata (ecografía) y crear ecos. Los ecos forman una imagen de los tejidos corporales denominada ecograma. La ecografía transrectal también se puede usar durante una biopsia.

  Ampliar

  Ecografía transrectal. Se inserta una sonda de ecografía en el recto para examinar la próstata. La sonda hace rebotar ondas sonoras en los tejidos corporales para producir ecos, los cuales forman una ecografía (imagen computarizada) de la próstata.

• Biopsia: extracción de células o tejidos realizada por un patólogo para observarlos bajo el microscopio. El patólogo examina la muestra en busca de células cancerosas y determina la puntuación de Gleason. La puntuación de Gleason varía de 2 hasta 10 y describe la posibilidad de que el tumor se disemine. Cuanto más baja la puntuación, menor la probabilidad de diseminación del tumor. Existen dos tipos de procedimientos de biopsia que se emplean para diagnosticar el cáncer de la próstata.
  • Biopsia transrectal: extracción de tejido de la próstata mediante la inserción de una aguja fina a través del recto hasta la próstata. Este procedimiento se suele practicar con ecografía transrectal para ayudar a guiar la aguja. Un patólogo examina el tejido al microscopio en busca de células cancerosas.

    Ampliar

    Biopsia transrectal. Se inserta una sonda de ecografía en el recto para mostrar dónde se encuentra el tumor. Después, se inserta una aguja por el recto hasta la próstata para extraer tejido de la próstata.

  • Biopsia transperineal: extracción de una muestra de tejido prostático mediante la inserción de una aguja fina a través de la piel entre el escroto y el recto hasta la próstata. Un patólogo examina el tejido al microscopio en busca de células cancerosas.

Ciertos factores afectan el pronóstico (la probabilidad de recuperación) y las opciones de tratamiento. El pronóstico (posibilidad de recuperación) y las opciones de tratamiento dependen de lo siguiente:

• El estadio del cáncer (ya sea que afecte parte de la próstata, que involucre toda la glándula o que se haya extendido a otras partes del organismo).
• La edad y la salud general del paciente.
• Si el cáncer ha sido recién diagnosticado o ha regresado.

El pronóstico depende también de la puntuación de Gleason y el índice de APE.

ACTIVITIES FOR MEN'S GROUPS

How to give life to your men's ministry

Ideas for Success

1. Pray for guidance, and that the Lord will help you select a few good men to plan and lead.

 

2. Set a date and invite these few good men to join you for a couple hours of prayerful planning.

 

3. Your purpose in this meeting is twofold:

First, to develop a statement of purpose for having your gathering of men. Keep in mind that this statement should satisfy the question, "Why a men's ministry?" Make it a short, simple, and spiritual statement that focuses on growth and God's purpose for men.

Second, to affirm and build the core group that will be key to the success of the ministry.

 

4. Use the art of brainstorming to develop some good ideas for the life of your group. Here's how to make this process work for you.

a. Brainstorming is offering all kinds of suggestions for the men's group. (Be sure you have someone to write the ideas down on a chalkboard or white marker board--and it should be someone who can write fast!). No one is to react to any idea negatively. In other words, if someone says , "Wouldn't it be a good idea to have a skydiver drop in with a special telegram from the governor?," you don't laugh or say, "that's silly!" Rather, you just keep the ideas flowing.

The faster the better, and what happens is fascinating: The imaginative mind seems to come unlocked and a stream of ideas flows out. Finally, when you have exhausted the ideas, you then review and rank them. Select your favorites and then develop the logistics of how the idea can work best for your situation. Pencil in events on specific dates as a "tentative" or "first draft" concept.

As you finesse your ideas you will have a whole list of possibilities and the well will never run dry for inspiring things to do.

 

b. If you come to a sticky point or have difficulty, simply pause and have prayer. Pray specifically that the Lord will give you ideas which will bless your men and lead them to a realization of their need to grow as Men of God.

 

 

5. Follow whatever process your church uses to carry out its programs. In most cases, this means plans need to be submitted to the church board for approval. The pastor can give guidance regarding what course to take and what he is comfortable with. In seeking the approval of the board (or whatever authority), be sure to explain the purpose of the men's ministry. The impressions people form will largely be positive if you assure and reassure that the purpose is to help men grow in their roles as husbands, fathers, and pillars of the church.

 

6. Request time during the Sabbath service to make a special presentation to the congregation. Describe the mission and purpose of the group and then hand out your calendar of events. Make sure that each event is well planned.

 

7. Keep your group focused on the spiritual goal of making "Men of God." Prayer, and the conscious presence of the Lord, must be an integral part of each event. Even the recreational and social events should have a rich ingredient of prayer and Christ-centered conversation. Avoid the low road of gossipy dialogs, or trivial, close-to-edge jokes. Always lead on the high road.

Make Christ the unseen guest at every event and verbalize your pleasure in His presence. He will make His presence real in our conversations, our mirth, and all our fellowship.

Set a goal that after every event, each man will leave with a lighter heart, lifted spirit, and fully encouraged to live for Christ in his home and at his work.

When a church has a group of men who consistently build each other up in their faith, a bonding of friendship and Spiritual support takes place. Each event, each gathering will become a golden chapter in our memories.

 

8. It is very, very important that men's ministries not become another event that takes men away from their families. In other words, for wives and families to be supportive of this ministry, they must see concrete evidence that the gathering achieved its goal. Their man must return home refreshed and recharged to walk as Christ in the presence of his family. The more the family experiences this, the more they are going to appreciate the time he spends with the men. This is not just "men being boys and having fun," rather it's "men who have come together to build better men for the sake of better relationships at home."

 

9. Develop a list of special songs to sing together. Have a musical person lead out with a guitar, piano, or even without accompaniment. Use songs that especially speak to men about consecration, the home, sacrifice, and building strength in the Lord. Create out your own booklet of songs on a word processor and print them in a neat format for your group.

 

10. Use one of your meetings to create a list of Bible promises that encourage men to trust in God's love. Encourage the men to fortify their hearts and their commitments by memorizing these promises and recalling them when needed during the day. Provide a "promise report" time during each meeting. This is a time for sharing how the words of Scripture "popped into my mind just when I needed it."

 

11. Ask the church to purchase a few books for men each month. These might be books that pertain to relationships in a Christian home, family worship, strengthening a marriage, parenting, or any other subject that helps men live the new life in Christ. Cataloge the books and loan them to the men at your meetings. Set aside a time for book reports at each meeting. Regularly hold up a book during Sabbath services so that your men will be aware of the good books that are available.

 

12. Frequently speak about the holy calling of men as priests of the home. Speak in positive ways of the man preparing himself daily with prayer and Bible study. One minister occasionally calls a man up on the platform during the worship service (having arranged with him beforehand, of course) and in an interesting way interviews him on his method of family worship, and elicits such things as the great blessing worship is to the family. Sometimes a wife can add a lot by simply adding how encouraging and strengthening it has been to the marriage and family since "Jim" has been leading out with worship. Some pastors do this often in conjunction with the children's story. Following the children's story, sometimes a set of parents is called up to the microphone and each offers a short prayer for every home, the school, and each child. The simple, earnest prayer of a mom and a dad can settle a cloud of God's glory on a congregation.

Sometimes grandparents may be invited to come right after the story and read a blessing for the children and each home represented in the congregation. When men come forward and give a testimony of their leadership activities at home it spreads throughout the congregation. The more we present these witnesses and their testimonies, the more compelling it becomes for each man to become the spiritual leader in his own at home. Testimonies are a powerful force to building Godly homes.

 

13. Plan a weekend campout just for fathers and kids. Have a campfire with lots of great, inspiring stories. Include a time when each father takes his own child or children for a "Memory Hike." At some point in the hike the father sits down with his children and very thoughtfully shares how much God really loves them and how much the loves them too. This is a good time for Dad to talk about the meaning of each child's name and share some of the feelings he had when he looked at them for the first time. If Dad takes this opportunity to share his personal testimony and describe how God is leading in his life, and then invite each child to rededicate their heart to God, the "Memory Hike" could well become a spiritual pillar in the life of each child.

 

You will want to use a few minutes in several of your men's meetings to plan for this hike. Have the men practice their testimony and their words of encouragement on each other. Also, let Mom know the approximate time this will take place so they can be on their knees in prayer at that time.

 

14. Hold a special communion service for your men. This can take place on a Friday night or early Sabbath morning, or even on a Sunday morning following a light breakfast.

Discuss the significance of submission, discipleship, and the value of strong brotherly love. Have large cups of grape juice, and giant thick biscuits of unleavened bread that will need to be broken and shared.

Set up an old rugged cross, and sing some carefully selected music. Create a atmosphere of quiet, non-rushed, contemplative sequence of events. Have the men read Psalms together, and maybe choose some Psalms to be read by one group and then another antiphonally. Sing "The Lord's Prayer," or "A Mighty Fortress Is Our God" to close the meeting. There may be those who want to share their feelings about their wife or family and express their desire to adorn them with their love. When they wash each other's feet ask them to especially pray for each other's marriage and family. Have them take the time to share with each other specific burdens relating to the family.

 

15. Some time ago I read about this gift idea, and I thought it might be creatively incorporated into one of our men's events. Purchase a large enough supply (52 for each man) of large size gelatin empty capsules. You can inform the men that they should bring a certain amount of money to cover the cost of this activity. Have a selection of at least 52 one-liners printed on a sheet of paper such as:

"One night's freedom from dishwashing"

"One pizza for the evening of your choice"

"One good, long walk together"

"One new outfit of your choice"

"One new nightgown of my choice"

 

You can come up with a large variety of "gifts"in a reasonably short time. Some will involve money, many won't. But each involves togetherness. Provide a sheet with the 52+ one-liners on it and a pair of scissors for each man. Have each man choose 52 and roll 'em up and insert 'em into the capsules. Put the pills into in a neat little bottle with a label that reads, "RX from Dr......" (your name) for (your wife's name). "To prevent the dulling of rnarriage, take one capsule every week for the next year." Half the fun is watching the wife fight off the urge to open all the capsules at once.

Some men may choose to write up some of their own one-liners. After all, he knows his wife best and he might tailor his treats to the delights that are unique to her.

Encourage each couple to choose a certain time each week when they can be together as she opens one capsule.

 

16. Divide the men into teams of three and invite each man to select a Scriptural passage that best describes the other two men in his group. As the men share the verses with each other - and explain why they selected them - the men in yur ministry will see each other, and themselves, much better. They will also quickly see how much God loves them.

These are just a few ideas for getting a meaningful Men's Ministries going in your church. But please do not delay! Get your men started on the upper road to becoming what God wants for them. We like the way Stu Weber put it:

"Men, you and I need to own for ourselves that same clarity of vision that so marked the life of Christ. We need to give ourselves up for our brides and the Bride as He did. So that the family might live well...... There's a world out there that needs some Tender Warriors. It's every man's purpose... every woman's dream... and every child's hope. It's the definition of a man. I want to head up that road. My prayers are with the men of this conference as we plan in our respective churches. I believe God has some wonderful things in store for us and our families that will be the result."