Androgenic Disease of Andropause   (Broad Overview)

Georges Debled  (October 5, 2019 - SEMAL Congress Seville)

Introduction

In recent years in the USA, prescription of testosterone in gel, injections or tablets in men having biology known as Low Testosterone has undergone considerable growth. “Testosterone clinics” have proliferated. By lack of discernment, “testosterone treatment” has given rise to severe cardiovascular complications and a multitude of class actions. Just check Google with keywords "testosterone " and "class actions" to see the number of lawsuits underway in 2019 in the US. Complaints concern patients, pharmaceutical companies, and insurances. Everyone rejects the responsibility for the disasters caused by the use of testosterone. In reality, all actors in these legal proceedings can both right and wrong. The problem comes from the fact that Low Testosterone Syndrome is not so easy to assess and that “andropause” is not a disease. Class actions are the consequences of disasters caused by testosterone treatments for signs that are not diseases (andropause — Low testosterone) while Androgenic Disease of Andropause and its treatment by mesterolone are constantly ignored or poorly understood.

History

“Andropause disease” was described more than thirty years ago [1-2-3]. However, “andropause” is still considered today as a non-pathological natural phenomenon such as menopause that is not a disease.  The expression Male Menopause is also commonly used, which makes no sense since man has no menstruations.

The purpose of this communication is to define the broad outlines of the Androgenic Disease of Andropause—in short, “Andropause disease,” it's diagnostic and its safe treatment by mesterolone on thousands of patients for forty years.

Definition

To define Andropause disease or Androgenic Disease of Andropause is not easy since there is no previous reference. When I wrote "Andropause, cause, consequences, and remedies in 1987,", I described not only a new concept but also a new disease. I chose the word andropause by what the dictionary described—in French, since 1952, the main symptom of the disease: "The natural cessation of sexual function in elderly men." (Le Petit Robert). In fact, after fourteen years’ experience starting in 1974, I described the “andropause disease” that has a cause: a decrease in secretion of androgens (testosterone and dihydrotestosterone) with age; has consequences: sexual impairment with or without general disorders; has a specific treatment with mesterolone that has properties of dihydrotestosterone) (mesterolone exists only since 1967).

 "Andropause Disease" — the Androgenic Disease of Andropause is the whole of physiological and psychological changes that accompany the natural and gradual cessation of sexual activity in man as a result of the decreased production of androgens (testosterone and dihydrotestosterone) [1]. Symptoms of androgen deficiency are well known [4].

Diagnostic

Androgen hormone production is a chain of biochemical reactions that starts with the transformation of cholesterol through various reactions to testosterone and ends with the production of dihydrotestosterone.

If the production of testosterone decreases with time (before or after forty), the decrease of dihydrotestosterone occurs first, and its metabolite androstanediol glucuronide also.

* The standards depend on the methods of analysis. That's why we always must refer to the same laboratory

It is thus possible to confirm also discrepancies between the level of testosterone and dihydrotestosterone if there is an early defect of 5 alpha-reductase.

The defect of dihydrotestosterone causes sclerosis of the prostatic musculature aggravated by the excess of estradiol [5-6].

Treatment

If there are no clinical or biochemical symptoms of sexual impairment, there is no andropause disease. If there is no disease, no hormonal treatment is justified.

Andropause disease occurs from forty and sometimes even before. It appears when androgens' production decreases significantly. Mesterolone is the ideal treatment.

The mesterolone molecule is a molecule of dihydrotestosterone on which a methyl radical has been grafted to C1. Through the liver, mesterolone loses its methyl radical, and dihydrotestosterone is released into the blood. As dihydrotestosterone has certain properties of testosterone, it can also compensate for testosterone deficiency without inhibiting the pituitary gland.

Under these conditions, the simplistic treatment with testosterone is contraindicated and can be harmful as evidenced by the many class actions in the US. Testosterone can be converted into estradiol, which aggravates genital symptoms and causes water retention before heart failure. While dihydrotestosterone gel inhibits the pituitary gland, mesterolone doesn’t and doses of 25 to 75 milligrams a day it is quite able to compensate for deficiencies in dihydrotestosterone and even testosterone without any danger whatsoever.