Kadiwala Ramiz S, Dhadwad Jagannath S
General Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Cureus. 2024 Jul 22;16(7):e65152. doi: 10.7759/cureus.65152. eCollection 2024 Jul.
Andropause is defined as late-onset hypogonadism that increases with advancing age and is diagnosed based on symptoms of hypogonadism like loss of libido, loss of morning penile tumescence, and laboratory confirmation of low testosterone. Unlike menopause, it is a slow and progressive condition with varying symptoms and presentations. There is very little awareness and insufficient utilization of screening methods, and the majority of the cases remain undiagnosed. This study was done to get deeper insight into this topic and elicit correlations among different variables. Objectives The primary objective is to assess the prevalence of andropause in diabetic and non-diabetic males aged 40-60 years in the Maharashtra state of western India. Material and methods After ethics committee clearance, exclusion criteria were applied, and 120 participants were enrolled over a period of 21 months. All enrolled subjects were thoroughly evaluated for andropause symptoms. An early morning venous blood sample was taken and sent for routine blood tests, including HbA1c, serum total testosterone, and serum luteinizing hormone. Total testosterone values were compared in patients with symptoms of hypogonadism, loss of libido, and erectile dysfunction. The effects of HbA1c levels, duration of diabetes, body mass index (BMI), smoking, alcoholism, and hypertension on hypogonadism and low testosterone were assessed. Luteinizing hormone levels were compared among the case and control groups in subjects with low total testosterone. Results Total testosterone levels were low for age, loss of libido and erectile dysfunction were more common, and symptoms of hypogonadism appeared at an earlier age in diabetics compared to non-diabetics. The duration of diabetes and HbA1c had a negative impact on serum testosterone levels and andropause symptoms. Diabetic patients with low testosterone levels had significantly lower LH levels. Conclusions Andropause is a syndrome of hypogonadism that occurs due to low serum testosterone levels. This study puts emphasis on secondary hypogonadism playing an important role in diabetic patients, causing the early occurrence of andropause in them. Glycemic control and BMI have a significant effect on both andropause symptoms and total testosterone levels, necessitating strict glycemic control and lifestyle modifications to delay or prevent the occurrence of andropause.
迟发性性腺功能减退随着年龄增长而增加，男性更年期被定义为迟发性性腺功能减退，并根据性腺功能减退的症状如性欲减退、晨间阴茎勃起消失以及实验室确诊睾酮水平低来诊断。与更年期不同，它是一种缓慢进展的疾病，症状和表现各不相同。人们对筛查方法的认识非常少，利用也不足，大多数病例仍未被诊断出来。本研究旨在更深入地了解这一主题，并找出不同变量之间的相关性。目的主要目的是评估印度西部马哈拉施特拉邦40 - 60岁糖尿病和非糖尿病男性中男性更年期的患病率。材料与方法在获得伦理委员会批准后，应用排除标准，在21个月的时间里招募了120名参与者。对所有纳入的受试者进行了男性更年期症状的全面评估。采集清晨静脉血样并送去进行常规血液检查，包括糖化血红蛋白、血清总睾酮和血清促黄体生成素。比较了有性腺功能减退症状、性欲减退和勃起功能障碍患者的总睾酮值。评估了糖化血红蛋白水平、糖尿病病程、体重指数（BMI）、吸烟、酗酒和高血压对性腺功能减退和低睾酮的影响。在总睾酮水平低的受试者中，比较了病例组和对照组的促黄体生成素水平。结果按年龄计算总睾酮水平较低，性欲减退和勃起功能障碍更为常见，与非糖尿病患者相比，糖尿病患者性腺功能减退症状出现的年龄更早。糖尿病病程和糖化血红蛋白对血清睾酮水平和男性更年期症状有负面影响。睾酮水平低的糖尿病患者促黄体生成素水平显著更低。结论男性更年期是一种由于血清睾酮水平低而发生的性腺功能减退综合征。本研究强调继发性性腺功能减退在糖尿病患者中起重要作用，导致他们更早出现男性更年期。血糖控制和体重指数对男性更年期症状和总睾酮水平都有显著影响，因此需要严格控制血糖和改变生活方式以延迟或预防男性更年期的发生。
