Sun, 08 Oct 2000

Male menopause not all gloom and doom

By Clare E. Urwin

SURABAYA, East Java (JP): Thanks to modern science and medicine, men can look forward to a satisfying and vibrant life in their later years.

This was the main message of a two-day symposium, Management of Erectile Dysfunction and The Aging Male, at The World Trade Center here last weekend.

There were six guest speakers, covering various aspects of the male aging process, and generally there was an optimistic theme throughout the day.

Jointly organized by Dr. Ramelan Navy Hospital and the School of Medicine of Hang Tuah University in Surabaya, the symposium was well attended by many interested professionals.

The meeting was held to commemorate the hospital's 50th anniversary and the school's 13th birthday.

Although knowledge about the female menopause is widespread, information about the aging male is limited. Men will require more consideration in the future. So, additional research is urgent and critical.

However, a general caution was also emphasized. With the worldwide increase in life expectancy, countries need to prepare for a much higher proportion of their citizens being older.

Aging does not have to mean a progressive decline in the quality of life, so extended good health is the new challenge in all societies today.

Wolf-Bernhard Schill, medical professor from Germany, discussed fertility in older men, a relevant topic since an increasing number of couples wish to have children in their middle and later years.

Unlike the rapid changes during the female menopause, fertility in men usually persists well into old age. In fact, children have been fathered by men over 90.

The problem of aging and its preventable options was the subject of Singaporean professor Victor H. H. Goh.

Asia is sitting on an aging population time bomb, he warned. Increased life expectancy and the costs of caring for an expanding aging population mean the strains on social and health services will be devastating.

Goh wanted to raise the awareness of this impending disaster and to issue a wake-up call for immediate Asian action.

The developed world became rich before it became old. The developing world will become old before it becomes rich, he added.

A holistic approach to managing aging has to be adopted. Prevention is much better than intervention as far as medical care for the elderly is concerned. Specific measures must include promoting a healthy lifestyle which will maintain Increasing health expectancy and a higher expectation of life should be the new catch phrase of our seniors. Although we cannot stop aging, we can certainly stop growing old.

Peter H.C. Lim, a medical professor from Singapore, discussed The Male Menopausem, the myths, facts and truths in the aging male and their treatment strategies.

Lim, looking remarkably youthful himself, is at present doing a random controlled trial into aging with one of the world's leading authorities in this field, David Hendelsman, a medical professor from the University of Sydney.

Male aging is called the andropausem -- something you don't believe in while you are young, the professor remarked.

He detailed the potential role of hormone replacement in the aging male.

The goal would be to improve body composition, increase muscle strength and enrich the quality of life.

Hormones are chemicals that the body produces from various glands, to help control the growth and repair of our tissues and organs throughout our lives. As we get older, our bodies produce less and less of them.

Researchers are studying hormones to find out if the decreasing levels are responsible, at least in part, for the diseases and disabilities in aging.

Tiny amounts of these powerful chemicals, whether made by the body or taken as supplements, can have widespread effects. Are they the elixir of youth? Can taking certain supplements prevent us from becoming old?

Key health-promoting hormone levels begin to decline by our mid-thirties. The principals ones involved are growth hormone, DHEA, testosterone, progesterone, estrogen and melatonin. At present, several research projects are underway which will soon reveal the benefits and risks of hormone supplements.

Naturally, any hormone replacement therapy must be carefully balanced and very closely monitored. It needs to be taken under controlled circumstances with proper back-up. The dangers of abuse are obvious.

An apt warning was issued against our vendor driven society where so called magic hormones are being touted and sold by ignorant charlatans.

However, an encouraging and promising view remains. Lim was enthusiastic about all the continuing research into aging. Within five years, real progress will be obvious and hopefully available to many he confidently stated.

Meanwhile, what can the ordinary person do while all this investigation is going on? We can make good choices about our lifestyle immediately.

Healthy eating, stopping smoking, managing stress, improving social interactions and proper exercise will all contribute to a long and satisfying life.

Especially relevant are recent studies showing that regular intensive exercise in older males means higher Growth Hormone and Testosterone levels. Its the cheapest and easiest method of anti- aging around!

The other speakers were a number of famous medical doctors and professor such as Akmal Taher, Panji Moeljono and Wimpie Pangkahila. Male sexual dysfunction, their consequences and treatment, and the involvement of diabetes mellitus were all discussed.

On Sunday, the symposium was open to the general public and again it was well attended. Lim and Akmal Taher talked in nontechnical terms about erectile difficulties and how the problem always involved the partner as well as the patient.

Although the recently launched Viagra represents a major and welcome breakthrough for sufferers of erectile dysfunction, it is not suitable for everyone. Lim described how the quest for developing newer therapies has already begun.

The whole subject was explained in an interesting and light- hearted manner, complete with slides, cartoons and anecdotes. An ideal way to reveal facts and offer solutions about a delicate topic.

Importantly, the speakers also avoided any possible embarrassment or awkwardness for the audience.

Sound, balanced, information was available and when the delegates left, they seemed both satisfied and heartened. The conclusion was that optimizing the life of our older citizens is definitely possible.