Men's Health: Detailed Explanation of the Causes and Countermeasures of Male Menopausal Syndrome and Gynecomastia
Male Menopause
The transition from childhood to adulthood is called puberty, and the transition from adulthood to old age is called menopause. These are two important transitional stages in a person's life. During both stages, physiological reasons and changes in the endocrine system can lead to behavioral abnormalities, psychological distress, and various mental anxieties.
During puberty, many teenagers may experience fear and anxiety about their first nocturnal emission due to a lack of sex education, or suffer from masturbation during puberty's sexual urges. These psychological and mental pressures can seriously affect the physical and mental health of teenagers. Similarly, during menopause, due to weakened gonadal function and decreased sex hormone levels, a person's personality and behavior can change. For example, a normally mild-mannered person may suddenly become irritable, and a very rational person may frequently lose self-control. Sometimes, dizziness, insomnia, panic, shortness of breath, and irritability may also occur, which is very detrimental to health care in old age. Therefore, everyone should understand and be aware of these two important transitional periods in their lives and be fully prepared for them. Entering this period, it's crucial to fully utilize one's subjective self-regulation abilities to counteract as many abnormalities as possible caused by changes in the endocrine system. Medication may be necessary in some cases.
For a long time, people have been very familiar with the physiological changes caused by endocrine system changes in women during aging—female menopause syndrome—and have conducted extensive research and effective clinical treatments for these abnormal physiological problems. However, the physiological changes caused by endocrine system changes in men during aging—male menopause syndrome—have not attracted the attention of medical experts and the public. This issue was only raised in the 1960s, and only recently has the term "male menopause" gradually been accepted by the medical community, leading to research and the search for solutions to this male-specific problem. Female menopause is caused by the gradual decline of female gonadal—ovarian function—and a decrease in estrogen levels. Similarly, male menopause is caused by the decline of male gonadal—testicular function—and a decrease in androgen levels, but this decline is much slower than in women. Therefore, male menopause is less pronounced than in women, and it occurs about 5-10 years later, around 55-60 years old. Most men experience little to no change during menopause, passing through this important period almost imperceptibly. However, some men are troubled by various discomforts associated with menopause, such as the aforementioned mood swings and decreased self-control.
A medical professional in his fifties, with nearly 40 years of experience, consistently showed care and consideration for his patients, maintaining a good service attitude. Starting at age 55, he began frequently arguing with patients and colleagues, which he found inexplicable. He sometimes experienced uncontrollable emotions, feeling anxious and restless all day, easily agitated and prone to tantrums. These symptoms gradually disappeared after three years. He himself found his behavior over those three years laughable. This is a typical manifestation of male menopause. Other possible symptoms include sexual dysfunction, impotence, decreased libido, reduced interest in life, irritability, occasional depression, and a preference for quiet and sedentary behavior. Studies have shown that approximately 65% of women and 45% of men experience a significant decrease in their activity levels during menopause.
For men with milder menopausal symptoms, clinical treatment may not be necessary, or appropriate behavioral adjustments can be made through self-psychological control. For patients with more pronounced symptoms that significantly impact their daily life and work, androgen therapy may be appropriate, such as 40mg of oryzanol once or twice daily. Medications to regulate autonomic nervous system function, such as oryzanol, vitamin B, and vitamin C, can also be used as supplementary treatments.
Gynecomastia (Male Gynecomastia)
Gynecomastia is a common endocrine hormone imbalance disorder, often occurring in the neonatal period and during male puberty. Incomplete statistics indicate that approximately 70% of males develop gynecomastia during puberty, mainly manifested as unilateral or bilateral, round enlargement centered on the nipple, accompanied by varying degrees of pain and a small amount of discharge. These symptoms generally subside gradually within six months to one year. Those with persistent symptoms should consult a doctor for examination and treatment if necessary.
(I) Causes of Gynecomastia in Males
1. Non-pathological imbalance of estrogen and androgen: Gynecomastia in newborns is generally believed to be caused by excessive maternal estrogen passing through the placenta to the fetus, resulting in higher estrogen levels than androgen levels in the newborn. This condition usually disappears within a few days after birth due to the newborn's own regulation, although in a few cases it may persist for several months. Gynecomastia in adolescence is caused by an imbalance in the secretion of estrogen and androgen. During adolescence, the functions of various organs are not yet fully developed and are easily affected by various factors. If estrogen secretion is excessive during this period for some reason, gynecomastia may occur. However, as the body matures, this imbalance is quickly corrected, and the gynecomastia disappears naturally. Therefore, gynecomastia in newborns and adolescent males generally does not require treatment.
2. Pathological Causes of Gynecomastia
① Hypergonadotropinemia: Gonadotropins may excessively stimulate testicular interstitial cells, altering the hormone biosynthesis pathway within these cells. This results in a relative excess of estrogen and its precursors in the synthesis and secretion of estrogen compared to testosterone, potentially leading to gynecomastia.
② Malnutrition and chronic diseases cause decreased serum gonadotropin levels. During the recovery period, gonadotropin levels rise, causing excessive estrogen secretion from testicular interstitial cells, resulting in gynecomastia.
③ Choriocarcinoma: Under normal circumstances, chorionic gonadotropins secrete appropriate amounts of human chorionic gonadotropin (hCG) to maintain normal sex hormone secretion. When these cells become tumors, they not only secrete excessive gonadotropins but also promote the conversion of estrogen precursors into estrogen, leading to elevated serum estrogen levels and gynecomastia. ④ Prolactinoma: In this disease, serum prolactin levels are significantly elevated. Prolactin can directly promote breast tissue development and can also relatively enhance the effect of estrogen on breast tissue by inhibiting the effects of testosterone on peripheral tissues.
⑤ Certain drugs, such as digitalis and spironolactone, can interact with estrogen receptors on breast tissue, causing breast development.
⑥ Idiopathic and familial gynecomastia may be caused by the hypersensitivity of breast tissue to normal levels of estrogen in these patients.
(II) Treatment of Gynecomastia
It is generally believed that most cases of gynecomastia in men are caused by a transient imbalance of estrogen and androgen levels under physiological conditions and do not require any treatment, gradually returning to normal within a short period of time. Only a few cases are caused by pathological reasons, requiring further examination at a hospital and appropriate treatment.