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Do men go through menopause?

Q: Is there really such a thing as "male menopause"? Men don't get hot flashes, do they? — Ed, Springfield, Pa.

A: They don't get hot flashes, but they can have problems on the other side of the dial ... as in, not getting hot enough. As men age, their testosterone levels take a slow-motion nosedive, and sexual desire — as well as their ability to get an erection — can fizzle.

But male menopause (andropause) is more than just involuntary celibacy. Guys can lose their energy and the power behind their golf drive or tennis serve as muscle strength ebbs. And, like women, they become more vulnerable to osteoporosis.

So, guys, if you're losing the hair on your head and can skip a day shaving (dwindling testosterone is an overzealous hairstylist), ask your doctor about a hormone test. You may be a candidate for testosterone therapy.

There are pros and cons: Testosterone therapy has been linked to prostate cancer, though that has been far from proven (otherwise, young men with raging testosterone would be felled by the thousands, and they're not). It does cause some prostate enlargement, but not enough to cause problems, such as urinary blockage.

On the pro side, it can correct the problems we just talked about (except for baldness, which it can worsen) and may decrease levels of lousy LDL cholesterol and improve insulin sensitivity, taking out one risk factor each for heart disease and diabetes.

Testosterone helps your muscles grow when you do resistance exercises, which also decreases the risk for diabetes, heart disease and even cancer. If your doc gives you the OK and you take it, don't expect to feel 30 at 50. But at least you won't feel 70.

Q: Two years ago, I was told I have pelvic prolapse, and now I'm afraid to leave my house because of all the problems that go with it. I am 73. Am I too old for the operation to fix it so that I can go on with my life? — Betty, via e-mail

A: Unless you have another medical condition that would make any surgery dangerous for you, the complications of prolapse — a weakening of the pelvic floor muscles that allow the vaginal walls or pelvic organs to drop from their normal positions and even bulge outside the body — make surgery your best recourse, no matter what your age.

Severe prolapse can destroy your quality of life faster than an F5 tornado, with urinary or fecal incontinence, painful intercourse and chronic abdominal and lower back pain. About 1 in 11 women have this condition, and in early stages, you often can manage the condition by doing pelvic floor exercises, keeping weight under control, avoiding caffeine, eating a high-fiber diet or taking stool softeners to prevent straining.

Once you begin to have serious complications, though, there are a few different types of surgical procedures to consider to restore your quality of life, including minimally invasive surgery that tightens the muscles and fascia that act like a sling to keep your insides from slipping outside. Talk to your doctor. Now.

Q: What is the regimen of baby aspirin to help your heart? What does it do, and when should you start taking it? — Anonymous

A: Those little pills can have a powerful effect on your heart. Aspirin helps keep your blood from clotting and has an anti-inflammatory effect on the arteries, both of which are useful for preventing heart attacks (to the tune of lowering your risk by 44 percent).

The regimen for taking it to help your heart is to down two baby (or "low-dose") aspirin (that's 165 mg total) a day with a warm glass of water. (Seventy percent of side effects are thought to be due to the aspirin landing on and eroding the stomach and intestinal lining, so better to have it land in the water.) It also decreases the risk of several cancers, including colon, breast and prostate by about 40 percent.

The question about who should take it is a little more complex. The calculations have typical men getting more benefit than risk from it at about age 45. But women may want to wait, unless they are taking estrogen: The heart protection doesn't kick in until they're over 65. But women at risk of stroke may want to start an aspirin regimen at age 55. No matter what your gender, don't start taking aspirin without your doc's OK.

The YOU Docs, Mehmet Oz and Mike Roizen, are authors of "YOU: On a Diet." Want more? See "The Dr. Oz Show" on TV (check local listings). To submit questions, go to www.RealAge.com.


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