Why heart failure brings on male menopause
A new study has found that heart failure accelerates the aging process and brings on early andropausal syndrome (AS), also known as "male menopause."
According to research presented Saturday at the Heart Failure Congress 2013, early andropausal syndrome (AS) was four times more common in men with heart failure.
As men age, they are more likely to suffer from andropausal syndrome (AS), androgen deficiency in the aging male (ADAM), or late-onset hypogonadism.
Men with andropausal syndrome, or AS, have decreased levels of anabolic hormones, including testosterone. It has therefore been suggested that these hormone deficiencies are what cause the clinical symptoms.
According to the Aging Male Symptom Rating Scale, the symptoms of AS can be divided into three categories as follows:
1) Sexual, such as having erectile dysfunction, problems with libido, decrease in beard growth, feelings of “having passed the zenith of life”;
2) Psychological, such as feeling discouraged, depressed, irritable, anxious, nervous; and
3) Somato-vegetative, such as having joint and muscle complaints, sweating, a need for more sleep, sleep disturbances, weakness, exhaustion.
Heart failure increases as men get older, and deficiencies of anabolic hormones are common in men with systolic heart failure, which leads to reduced exercise capacity, depression and poor prognosis.
Until now, however, the impact of heart failure on the prevalence of AS and the severity of andropausal symptoms has not been studied.
Accordingly, researchers launched a study to see what they could find.
"AS leads to poor quality of life. We wanted to discover whether heart failure increases AS and whether additional androgen therapies could improve quality of life in heart failure patients," said Professor Ewa A. Jankowska, who is from Wroclaw, Poland.
For the study, Jankowska and a team of researchers compared the prevalence of AS and the severity of andropausal symptoms between 232 men with systolic heart failure aged 40-80 years and 362 age-matched healthy peers.
The magnitude of andropausal symptoms (psychological, sexual and somato-vegetative) was assessed using the Aging Males' Symptoms (AMS) Rating Scale and AS was diagnosed if the total AMS score was 50 points or more.
They found that AS affected nearly one-third of men with heart failure, regardless of their age group.
In men between the ages of 40 and 59 years, heart failure led to a four-fold increase in the prevalence of AS (28% vs. 7%) and an increase in the severity of sexual and somato-vegetative andropausal symptoms.
In men aged 60-80 years, with and without heart failure, they too had a similar prevalence of AS and severity of andropausal symptoms.
Among men with systolic heart failure, the prevalence of AS was similar in both age groups (40-59 and 60-80 years).
The authors concluded that heart failure accelerates the natural process of aging and brings on the early onset of AS.
"Heart failure leads to anabolic hormone deficiencies at a relatively young age and thereby accelerates male aging and the development of AS,” said Jankowska. “These patients have poor quality of life and need endocrinological and sexual counselling."
According to the research team, it has been suggested that the anabolic hormone deficiencies in heart failure could be caused by heart failure treatments, which could affect the metabolism of hormones that might impair endocrine gland function.
However, in a second abstract, the researchers found only a few weak associations between the presence of anabolic deficiencies, metabolism of hormones, and therapies in men with systolic heart failure.
"This shows that it is the heart failure itself which impacts on the functioning of the endocrine glands," Jankowska explained.
"Further research is needed to determine whether androgen supplementation can reduce the severity of andropausal symptoms," she concluded.
SOURCE: European Society of Cardiology, Andropausal syndrome in men with systolic chronic heart failure, Presented at Heart Failure Congress 2013, Final Program Number P6240