For decades the reduction of sex hormones in post-menopausal women has been the subject of study and for decades women presenting with associated problems have been treated with female hormones. Nowadays a deficiency of active androgens like testosterone in men is known not as andropause but as padam, or Partial Androgen Deficiency in the Ageing Male. Every ten years those in the field dream up a new acronym. The term ‘penopause’ is, however, no longer current.
In contrast to the position with women, treatment of the ageing man with a deficiency of androgens is still in its infancy. Administering testosterone to ageing men may have a favourable effect on the previously mentioned symptoms. But what men should be treated? Up to now there has been no research on which to base an adequate answer to this question. The administering of testosterone to ageing men with ‘normal’ testosterone levels in their blood serum but with a typical pattern of symptoms is currently the subject of debate, but unfortunately the research that has been carried out has been with ‘healthy’ older men and there have been no double-blind placebo-controlled studies. In the latter the effects of a possible drug are compared with those of a placebo, where neither the researcher nor the test subject knows which drug is being administered or taken.
As indicated by the term padam, older men suffer only from a partial deficiency, which fact needs supplementing only to the normal level. Until recently that could be done only with capsules or injections. The use of skin patches is also possible, but the best way appears to be the daily application of a gel to the chest and shoulders. Two makes are available commercially, one smelling of perfume, the other of pure alcohol — take your pick. Finally, testosterone can also be administered via a bio-adhesive tablet on the gum above the upper incisor teeth.