finger on the pulse : Do men have a menopause?

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DO MEN have a menopause, and if so are they concerned about it? They certainly seem to hit a crisis point in their 40 and 50s, but is this environmental or biological?

Of course, men can't actually have a menopause. But at a recent international conference on the menopause (the female version) in Australia, I heard a new term coined for the male whatever-it-is. This was PADAM - Partial Androgen Deficiency of the Ageing Male. As men get older, their testosterone levels get lower, and then their libidos go down. By 80, one in five men will have very low levels of testosterone. As with women, this can have an effect on heart, bones and muscular strength.

Until recently, women used to accept that as they got older, bits shrivelled up or snapped off. This has changed. Rather than accept the inevitable, we now have choices about how we shape our future selves, physically and mentally. We know that HRT helps to prevent osteoporosis and heart disease, and may also slow down Alzheimer's. By the age of 55, 40 per cent of women in this country now take HRT.

However, there has been little research looking at the male ageing process. Up to now, men themselves did not seem very interested in their appearance or their health. This has all changed - witness the upsurge in male magazines out on the racks.

Men are much more likely to seek help if they lose their sex drives. They will no longer accept impotence, and want reasons and treatment for their problems. Testosterone replacement is certainly not an answer to all these problems: sex is a complicated business. If libido is down, it may be psychological or due to depression, diabetes or even medication such as beta-blockers used for the treatment for hypertension.

A testosterone patch was launched in the UK last year. It has been targeted at men whose bodies produce no testosterone. This, as yet, has not been seen as a routine treatment for the decline of testosterone as a result of increasing age. At the moment we don't even routinely check men's testosterone levels as they get older, to see who could benefit from treatment. Before giving testosterone, it's also necessary to screen for prostate cancer. Testosterone given to someone with a microscopic prostate cancer could make it grow. A blood level measurement of a substance called prostate specific antigen and a rectal examination is needed before treatment begins. So, as with HRT, testosterone therapy is not something that can be prescribed without caution.

Will this be a panacea for all men's problems? Alas, no. Often there are many other factors in play to make a man alter his behaviour. It sometimes has nothing to do with hormones.

But in the next few years, we will see answers to some of the questions of male ageing. Testosterone has recently been used in research cases to treat male osteoporosis. As with female hormone replacement therapy, we are at an early stage to see all the benefits and more research is required. But who knows, maybe we'll see matching his 'n' hers patches in a few years' time.