Male Andropause : A Myth or Reality

From couplepause to doublepause: the impact of midlife physical, psychological, and social changes on the sexual life of aging couples

INTRODUCTION

Midlife men and women are facing frequent sexual problems that affect not only individuals' sexual health but also the sexual health of aging couples.

OBJECTIVES

To review the main sexual life challenges faced by midlife couples, to present the concepts of couplepause and doublepause as 2 new paradigms to address the sexual health needs of aging couples, and to discuss key aspects in couple-focused care.

METHODS

An online meeting attended by 5 European experts in sexual health was carried out in June 2023 to discuss the topic. The conversation centered on their clinical experience and expert opinion. Additionally, the indexed literature was reviewed to endorse and complement the expert opinions obtained in the aforementioned meeting.

RESULTS

Midlife men and women face physical, psychological, and sociocultural changes that affect their sexual activity. These changes may be experienced differently between genders. Both members of a couple may experience age-related changes concurrently or in an unsynchronized manner affecting their sexual health. Communication, sharing expectations, defining sexual dynamics, and couple goals are determinant for the sexual health of a midlife couple. Couplepause and doublepause are 2 new complementary paradigms that effectively address the sexual health needs of aging couples as a unit, considering physical, psychological, cultural, social, and dyadic-related factors. Couple-centered strategies should promote open communication about couple intimacy issues, understanding the diverse expectations according to gender and orientation, communication styles, and goals. The following are identified as crucial aspects to promote couple-focused care: education and training of health care professionals, the provision of information to aging couples, physician involvement in addressing sexual problems, the need for collaboration across medical specialties, and the development of effective tools and strategies.

CONCLUSIONS

The sexual problems of aging couples should be managed following couple-centered strategies that effectively address their sexual health needs as a couple.

Late-onset hypogonadism (LOH), masculinity and relationship and sexual satisfaction: are sexual symptoms of LOH mediators of traditional masculinity on relationship and sexual satisfaction?

Background Late-onset hypogonadism (LOH) is characterised by significant changes in the male life cycle, and may increase the likelihood of experiencing sexual difficulties. Further, it is assumed that traditional gender roles (masculinity) can affect the experience of sexual difficulties. The aim of this study was to evaluate the effect of masculinity on sexual symptoms of LOH, as well as on sexual and relational satisfaction.

METHODS

A community sample of 460 Portuguese men aged between 40 and 91 years (mean (± s.d.) 51.64 ± 8.03 years) was collected. Correlation and moderation analyses were conducted to investigate relationships among the variables being studied.

RESULTS

There was an association between the sexual symptoms of LOH, masculinity and sexual and relationship satisfaction. Moderation analysis revealed direct relationships between masculinity and sexual and relationship satisfaction, as well as direct relationships between sexual symptoms of LOH and sexual and relationship satisfaction. However, sexual symptoms of LOH did not significantly moderate the relationships between masculinity and sexual and relationship satisfaction.

CONCLUSIONS

These findings indicate the existence of a direct effect of both masculinity and sexual symptoms of LOH on sexual and relational satisfaction, although masculinity did not have an effect on sexual symptoms of LOH. The implications of these findings are discussed. Instrumentality as an indicator of masculinity was associated with relational and sexual satisfaction, suggesting the importance of involving a man's partner in sexual dysfunction interventions.

Knowledge and Attitude about Andropause Among General Physicians in Shiraz, Iran 2014

BACKGROUND

Andropause in men refers to the clinical and biochemical syndrome associated with advanced age and characterized by a deficiency in serum testosterone levels. With the increase in aging male population and life span in Iran and focus on quality of life, andropause will become a major health issue that needs to be addressed in order to prevent disability. The results of some research have shown that there is still low level of knowledge and attitude toward andropause among health professionals. This study aimed at assessing the level of knowledge and attitude of general physicians regarding andropause in 2014.

METHODS

This cross-sectional study was carried out on 402 general physicians in Shiraz. A researcher-made questionnaire was developed for assessing the level of knowledge and attitude of general physicians about andropause. SPSS 18 was used to analyze the data, and descriptive statistics, ANOVA and Pearson correlation were applied for data analysis.

RESULTS

The mean score of knowledge and attitude about andropause was 29.4 out of 76 and 35.1 out of 45, respectively. The findings showed a poor level of knowledge and positive attitude toward andropause among general physicians. There was a significant relationship between occupational status and knowledge about andropause (P<0.001). There was a statistically significant relationship between attitude and demographic characteristics (P<0.05). The correlation between knowledge and attitude toward andropause was not statistically significant (P=0.548).

CONCLUSION

The findings of the present study indicate the need for designing educational interventions to improve the knowledge and attitude of andropause among general physicians.