This document discusses male and female climacteric changes. It describes andropause or male menopause as age-related changes in men over 50 that involve a drop in testosterone levels and similar symptoms to hypogonadism. Common symptoms include low energy, depression, erectile dysfunction and reduced muscle mass. Diagnosis is based on history, exam and testosterone blood levels. Lifestyle changes and testosterone therapy are management options. Menopause in women occurs between 45-55 and involves stopping periods due to declining estrogen levels. Symptoms last 4 years and are managed with hormone replacement therapy, lifestyle changes or mindfulness.

1. B Y
L O R I T A F U R T A D O
CLIMACTERIC
CHANGES

2. MALE CLIMACTERICS = ANDROPAUSE

3. MALE MENOPAUSE/ ANDROPAUSE
• Describes age-related changes in male hormone levels.
• Involves a drop in testosterone production in men who are
age 50 or older. It’s often affiliated with hypogonadism. Both
conditions involve lowered testosterone levels and similar
symptoms.
• Not all men experience it
• It doesn’t involve a complete shutdown of reproductive
organs. However, sexual complications may arise as a result
of your lowered hormone levels.

4. SYMPTOMS OF ANDROPAUSE
Male menopause can cause physical, sexual, and psychological problems.
They typically worsen as one gets older. They can include:
• low energy and decreased motivation
• depression or sadness
• lowered self-confidence
• difficulty concentrating
• insomnia or difficulty sleeping
• increased body fat
• reduced muscle mass and feelings of physical weakness
• gynecomastia, or development of breasts
• decreased bone density
• erectile dysfunction; reduced libido; infertility
• Some may also experience-swollen or tender breasts, decreased testicle
size, loss of body hair, or hot flashes and osteoporosis.

5. DIAGNOSIS AND MANAGEMENT OF
MALE MENOPAUSE
• Diagnosis: Based on history, Physical Examination and
Blood testosterone levels
• Treatment:
• Unless male menopause is causing severe disruption of life
most of the symptoms can be managed without treatment.
• Healthy lifestyle choices like eating a healthy diet, regular
exercise, getting enough sleep and reducing stress result in
dramatic positive change in overall health of men
experiencing symptoms.
• Use of Hormone replacement therapy is very controversial as
synthetic testosterone can have damaging side effects.
• If experiencing depression antidepressants and
psychotherapy can be done.

6. FEMALE CLIMACTERICS = MENOPAUSE

7. MENOPAUSE
• The menopause is
when a woman stops
having periods and is
no longer able to get
pregnant naturally.
• The menopause is a
natural part of ageing
that usually occurs
between 45 and 55
years of age, as a
woman's oestrogen
levels decline.

8. Menopausal symptoms can begin months or even years before menstruation stops and last
around 4 years or sometimes even longer after the last menstrual cycle

9. CAUSES
• The menopausal transition, and postmenopause itself, is a natural change, not usually a
disease state or a disorder. The main cause of this transition is the natural depletion and
aging of the finite amount of oocytes (ovarian reserve). Other causes are:
 Age
 Premature Ovarian Failure- is when the ovaries stop functioning before the age of 40
years. It is diagnosed by high blood levels of FSH and LH on at least three occasions at
least four weeks apart.
• Known causes of premature ovarian failure include autoimmune disorders, thyroid disease, diabetes
mellitus, chemotherapy, being a carrier of the fragile X syndrome gene, and radiotherapy.
• However, in about 50–80% of spontaneous cases of premature ovarian failure, the cause is
unknown, i.e., it is generally idiopathic.
 Early menopause can be due to
• cigarette smoking,
• higher body mass index or being extremely thin
• racial and ethnic factors, illnesses,
• surgical removal of the ovaries, with or without the removal of the uterus
• Undiagnosed and untreated coeliac disease is a risk factor for early menopause
• . Hysterectomy with ovary conservation
• Women who have a functional disorder affecting the reproductive system (e.g., endometriosis,
polycystic ovary syndrome, cancer of the reproductive organs) can go into menopause at a younger
age than

10. MECHANISM

12. DIAGNOSIS
• Menopause rating scales.
• Premenopause- is a term used to mean the years leading up to the last period,
when the levels of reproductive hormones are becoming more variable and
lower, and the effects of hormone withdrawal are present. Premenopause starts
some time before the monthly cycles become noticeably irregular in timing.
• Perimenopause- refers to the menopause transition years before the date of
the final episode of flow. This transition can last for a six- to ten-year phase
ending 12 months after the last menstrual period. During this period wide
fluctuations in estrogen levels is seen which cause many of the physical
changes like hot flashes, night sweats, difficulty sleeping, mood swings, vaginal
dryness or atrophy, incontinence, osteoporosis, and heart disease. During this
period, fertility diminishes but is not considered to reach zero until the official
date of menopause.

13. DIAGNOSIS
• Postmenopause- describes women who have not experienced any menstrual flow
for a minimum of 12 months, assuming that they have a uterus and are not pregnant
or lactating.
• In women without a uterus, menopause or postmenopause can be identified by a
high FSH level. The reason for this delay in declaring postmenopause is because
periods are usually erratic at this time of life. Therefore, a reasonably long stretch of
time is necessary to be sure that the cycling has ceased.
• At this point a woman is considered infertile; however, the possibility of becoming
pregnant has usually been very low (but not quite zero) for a number of years before
this point is reached.
• A woman's reproductive hormone levels continue to drop and fluctuate for some time
into post-menopause, so hormone withdrawal effects such as hot flashes may take
several years to disappear.
• A period-like flow during postmenopause, even spotting, may be a sign of endometrial
cancer.

14. MANAGEMENT
• Hormone Replacement Therapy (HRT)- use of estrogen in
women without a uterus and estrogen plus progestin in women who
have an intact uterus-tablets, skin patches, gels and implants that
relieve menopausal symptoms by replacing oestrogen
• Selective estrogen receptor modulators- Eg: Tamoxifen
• vaginal Oestrogen creams, lubricants or moisturisers for vaginal
dryness
• Mindfulness and cognitive behavioural therapy (CBT) – a type of
talking therapy that can help with low mood and anxiety
• eating a healthy, balanced diet and exercising regularly–
maintaining a healthy weight and staying fit and strong can
improve some menopausal symptoms

15. REFERENCES
• https://www.healthline.com/health/menopause/male#diag
nosis-and-treatment
• https://www.nhs.uk/conditions/menopause/
• https://en.wikipedia.org/wiki/Menopause
Thank You