Andropause is known as the gradual decline of testosterone levels, usually a phenomenon occurring in aging men. While its female counterpart, menopause, has been well-researched and understood, andropause is more complicated to monitor and study, as it has no pattern-like hormonal cutoff, which is difficult when trying to study its effects on various diseases, including the likes of multiple sclerosis. Disparate from menopause in women, andropause includes a measured decrease in testosterone and testicular function, across the span of multiple years. Many studies suggest that this decline in testosterone can lead to the development of multiple sclerosis, which would explain why male M.S. patients usually develop the disease far later than female patients.
Research shows a connection between low testosterone levels and increased risk of multiple sclerosis, potentially explicating the role of androgens in immune response and neuroprotection relating to M.S. Androgens, with testosterone, show to demonstrate anti-inflammatory effects that could impact M.S. progression. Alongside this, they can potentially play a role in remyelination, a process necessary to repair the damaged nerves that M.S. patients have symptoms. Through understanding the relationships that testosterone levels, M.S. progression, and aging have, we can at the very least attempt to clarify the mechanics that stimulate general disease development and progression in older, male patients.
Compared to healthy individuals, findings reveal that males with multiple sclerosis have lower testosterone, again playing into potential explanations for disease progression and degree of severity. Something else to note is that male M.S. patients experience later onset (of M.S.), less relapses, but more intense disability progression when compared to their female counterparts. This implies that there is a relationship between the reproductive senescence, testosterone levels, and progression course of multiple sclerosis in men.
Clinical trials have explored the positive side effects of testosterone replacement therapy for males with M.S., with promising results of increased cognition and neuroprotection (essential for M.S. recovery). Trials like these highlight how testosterone can be used as an adjacent therapy in management of multiple sclerosis, which can fulfill the unique needs of males with the disease.
Citations
Ysrraelit, Maria C., and Jorge Correale. “Impact of Andropause on Multiple Sclerosis.” Frontiers in Neurology, vol. 12, 2021, https://doi.org10.3389/fneur.2021.766308.
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