PREVALENCE OF ANDROPAUSAL

SYMPTOMS AMONG KUWAITI MALES

_____________________________
SITI NUR AMALINA
 JOURNAL
 American Journal of Men’s Health
 Year : 2013
 Volume : 7
 Issue : 6
 Page : 516-522
 AUTHOR
Al-Sejari Maha, PhD ¹

Department of Sociology and Social Work, College of Social Science, Kuwait

University, Kuwait
 HEADINGS
1. Abstract
2. Introduction
3. Materials and method
4. Results
5. Discussion
6. Conclusion
 1. ABSTRACT
Background
 Andropause is a syndrome that usually occurs during men’s midlife

Objective
 To identify the factors that significantly contribute to the prevalence of symptoms that may be related
to androgen deficiency

Materials & method

 Cross-sectional structured questionnaire
 Sample of 214 Kuwaiti men (aged 40 years and older)
 Questionnaire consist of:
1. Sociodemographic characteristics of participants
2. Androgen Deficiency of the Aging Male Scale of Andropausal Symptoms
Results
 Kuwaiti men aged 40 to 49 years old reported fewer symptoms than Kuwaiti men aged 50 years and
older
 40 to 49 years old- lower education level, marital status & employment status were significantly
associated with the men’s symptom
 50 years and older-only education level was significantly associated with their symptoms

Conclusion
 The findings will offer insight into the necessary health care provision to educate, treat and provide
information related to andropause for the general public
 2. INTRODUCTION
 Men experience biological, psychological and endocrinological changes at midlife, caused by
hypogonadism and reduction in total testosterone levels

 The Endocrine Society defines androgen deficiency in men as a clinical syndrome that results from a
failure of the testes to produce physiologic levels of testosterone

 Men who were diagnosed with late onset hypogonadism (LOH) have reported experiencing abnormal
reduction in their levels of testosterone due to hypothalamic-pituitary disorder or testicular disease

 The prevalence and intensity can vary depending on their age, presence of chronic disease, and
variations in androgen sensitivity

 About 1/3rd of men in their 60s and >80% of men aged 80 or older experience physical & psychological
changes
 3. MATERIAL & METHOD
Study design
 Cross sectional study

Study period
 2011

Study area
 Kuwait

Study population
 Kuwaiti men between the ages of 40 and 70
Study variable 14 signs/symptoms associated with
Personal characteristics of the testosterone deficiency
participants 1. Hot flushes
1. Age 2. Sweating
2. BMI 3. Loss of height
4. Decrease in strength
3. Educational level
5. Deterioration in ability to play sports
4. Marital status
6. Falling asleep after dinner
5. Employment status
7. Fatigue/weakness
6. Medical history
8. Loss of sexual desire
7. Smoking habit 9. Erectile dysfunction
8. Physical activity 10. Inability to concentrate
11. Irritability
12. Depression
13. Anger
14. Memory loss
Sample size
 214 healthy Kuwaiti men
 40-49 years
 50 years and older
4.RESULTS
 143 were in the age group of 40-49 years
 71 were 50 years and older
 Mean 48.07 years

 40-49 years (75%) had BMI below 29

 50 years and older (30.4%) had BMI below 29

 40-49 years (70.6%) achieved middle education

 50 years and older (29.4%) achieved middle education

 40-49 years (83.8%) currently working

 50 years and older (16.2%) currently working

 40-49 years (65.2%) were married

 50 years and older (34.8%) were married

 40-49 years (59.5%) never exercised

 50 years and older (40.5%) never exercised

 40-49years (63%) unaware the term of andropause

 50 years and older (32%) unaware the term of andropause
Main andropausal symptoms reported by Kuwaiti men aged 40-49
years:
 Notice deterioration in the ability to play sports – 82 men
 Weakness/fatigue – 56 men
 Irritability & anger – 43 men
 Inability to concentrate – 42 men
 Anxiety – 39 men
 Sweating – 18 men
 Less strength in erection – 21
 Depression – 22 men
 Decreased libido – 30 men

Main andropausal symptoms reported by Kuwaiti men aged 50 and

older:
 Weakness & notice decrease in athletic performance – 41 men
 Inability to concentrate – 40 men
 Irritability – 38 men
 Decrease libido – 31 men
 Anxiety – 26 men
 Depression – 9 men
 Hot flushes – 12 men
 Sweating – 19 men
15 respondent in the age group 40 – 49 years reported no symptoms
4 respondent in the age group 50 and older reported no symptoms

 Pearson’s correlation was applied to examine the association between each age group’s demographic
characteristics and the 14 ADAM symptoms
 Differences were considered significant at p<0.05

For respondent age group 40 to 49 years:

 Significant association between who accomplished lower education with falling asleep after dinner and
hot flushes (p<0.05)
 Significant association between respondent employment status with falling asleep after dinner, anger
and hot flushes (p<0.05)
 Significant association between marital status with feeling weak when they play sport (p<0.001)

For respondent age group 50 and older:

 Significant association between education level with body weakness and fatigue, loss in sex drive,
noticeable deterioration in physical activity, falling asleep after dinner and sweating (p< 0.05)
 5. DISCUSSION
 Respondents aged 50 years and older reported experiencing more andropausal symptoms

 The findings of the current study are comparable to those of several studies that also reported a significant association
between middle-aged men’s experience of various andropausal symptoms and their marital status, education levels,
and occupations

 Respondents aged 50 years and older who achieved lower education reported more symptoms than those in the same
age group with middle and higher educational levels

 The current study cannot ascertain a causal connection between an average age-dependent decline in testosterone
production and andropausal symptoms

 A study conducted by Al-Sejari (2013) that examines the relationship between men’s perceptions and attitude towards
andropause reveals that
o 36% acknowledged having signs of andropause
o 38.4% believes that men do not go through andropause
o 53.4% do not know at what age men experience andropause
o 46.9% think that andropause is a sign of aging
Limitations:
1. Majority of the respondents were in the age group of 40 to 49 years

2. Due to the sensitivity of the research topic, many men are uncomfortable participating in this study

3. This is the 1st research of its kind conducted in Kuwait that discusses and measures the prevalence and
intensity of andropausal symptoms using a constructed questionnaire and clinical and laboratory
research using both blood samples to asses androgen deficiency and the frequency of andropausal
symptoms
 6. CONCLUSION
 Andropause as a health condition is difficult to recognize by a majority of men because of
the lack of knowledge of its etiology, pathophysiology and management

 Kuwaiti men attributed the decline in their health and well-being to chronic disease,
fatigue, and aging rather than endocrinological imbalance

 The findings of this study showed that it is important to educate the public, especially
men, about andropause