Sweating Attacks: Key Symptom in Menopausal Transition Only for Women?

Gender differences in climacteric symptoms and associated factors in Korean men and women

Both men and women may experience multifaceted symptoms that are part of natural aging throughout the climacteric period. This study compared the prevalence and severity of climacteric symptoms between genders and identified the underlying clusters of climacteric symptoms and associated factors in midlife men and women. A cross-sectional study was done with 254 middle-aged Korean men (n = 129, M = 50.4) and women (n = 125, M = 49.5). Data were collected by self-administered surveys and analyzed using t-tests, chi-square tests, exploratory factor analysis, and regression analysis. Significant gender differences in overall climacteric symptoms were not detected except for muscle weakness, weight gain, and hot flashes. Climacteric symptoms were clustered as physical, vasomotor-genital, psychological, and metabolic dimensions, with the physical dimension being the most explanatory cluster. A significant gender effect was found only in the metabolic dimension after adjusting for the relevant covariates, and regular eating was significantly associated with all symptom clusters. This study offers evidence that most climacteric symptoms are shared by both men and women and emphasizes the importance of healthier lifestyles in the climacteric transition period. The findings highlight the critical need for integrated assessments of the multifactorial symptoms and of modifying poor lifestyles in both genders throughout the climacteric transition period.

Andropause - state of the art 2015 and review of selected aspects

The term ‘male menopause’ was first used in 1944 to describe various complaints of ageing men which at least partially mirrored the climacteric symptoms in women. Continuous research resulted in the evolution of opinions about the nature of these complaints, from the clinical syndrome, diagnosed with the use of disease-targeted questionnaires, to a well-defined clinical and biochemical syndrome. The pathophysiological causes – gonad ageing (with a compensatory rise in luteinizing hormone), age-related increase in serum sex hormone-binding globulin (SHBG) levels, the role of visceral adipose tissue as a place for aromatization of androgen to estrogen, and lower sensitivity of testosterone receptors – have been described. However, no consensus was reached as far as the definition, incidence, treatment, and especially testosterone therapy, are concerned. Our review presents the current standpoints, indicating the predictive role of late-onset hypogonadism (LOH) in evaluating male health as well as the current literature reports on the risks and benefits of using testosterone therapy.

Hot flashes in prostate cancer: state of the science

The lack of progress concerning the concept of the hot flash experience in men is an indication of the need for exploration of this phenomenon. The hot flash experience in men is a problem that can no longer be ignored. The results of this literature review will provide a foundation for additional development of the concept and facilitate further inquiry into the phenomenon. The purpose of the article is to provide the current state of the science of hot flashes related to androgen ablation treatment in prostate cancer patients; sleep, sweating, cognitive impairment, and the implications on health-related quality of life. Due to the sparse literature on this concept in men, information is extrapolated from the literature on female breast cancer patients treated with hormones and on menopausal women.

Hot Flash Experience in Men With Prostate Cancer: A Concept Analysis

PURPOSE/OBJECTIVES

To provide a clear definition of the hot flash experience in men with prostate cancer receiving hormonal treatment.

DATA SOURCES

Articles, book chapters, and electronic sources.

DATA SYNTHESIS

The hot flash experience has not been explored previously in men with prostate cancer. The physiologic and psychological scopes of the phenomenon are described as a multidimensional experience.

CONCLUSIONS

The essential attributes of hot flashes in men consist of physiologic (e.g., warmth, sweating, chills) and psychological (e.g., anxiety, impaired memory, agitation) factors. Antecedents to the experience include demographics, disease, and treatment modality. Consequences include effects on sleep, cognition, and health-related quality of life.

IMPLICATIONS FOR NURSING

Evaluation of the hot flash experience in men receiving hormonal ablation should include assessment of the symptoms associated with the treatment modality and nursing interventions to help ameliorate symptoms. Future research is needed to focus on providing symptom management to decrease the severity or prevent the occurrence of multiple symptoms related to androgen ablation therapy.

Aging Males’ Symptoms scale in Japanese men attending a multiphasic health screening clinic

OBJECTIVES

The Aging Males' Symptoms (AMS) scale is a health-related quality-of-life scale. The AMS scale has been used worldwide for the evaluation of andropause symptoms, but its standardized values have only been published for Germany. We sought to evaluate the prevalence of andropause symptoms in the male Japanese population using the AMS scale.

METHODS

Of a consecutive series of 2833 men who underwent multiphasic health screening at Kurashiki Central Hospital, we analyzed the results for 2211 men who responded to all questions on the AMS scale.

RESULTS

The severity of the total score and the sexual subscore of the AMS scale increased significantly with age, but no significant age relationships were observed in the psychological and somatic subscores. Approximately 50% of men in their 40s had moderate or severe symptoms in the sexual subscore. The total scores and all subscores for the Japanese population were significantly greater than those for the German population.

CONCLUSIONS

A decline in sexual function with age was demonstrated in healthy Japanese men, but the somatic and psychological subscores were not influenced by age. The present study has provided standardized values for the AMS scale for the Japanese population.

Scale for Quality of Sexual Function (QSF) as an Outcome Measure for Both Genders?

BACKGROUND

For years, there has been interest in sexual dysfunction and its impact on quality of life but usually focused on one gender. Therapeutic options that became available raised the interest to evaluate effects on the other partner but there is no standardized instrument applicable for both genders. This paper reports first data regarding the development of a new general "Quality of Sexual Function" (QSF) scale.

METHODS

The raw scale was based on our own gender-specific scales and the pertinent literature. The scale was applied in over 700 persons of a cross-sectional survey in Germany. Factorial analyses were performed to describe the internal structure (domains) of the scale and for item reduction. Internal consistency reliability and some aspects of validity were analyzed with the same community sample preliminary reference values determined.

RESULTS

The scale consists of 32 specific items and eight general questions. Four dimensions were identified: "psycho-somatic quality of life,""sexual activity,""sexual (dys)function-self-reflection," and "sexual (dys)function-partner's view." The internal consistency reliability coefficients of the total scale and the subscales were good as were the total-domain correlations. Content validity was promising.

CONCLUSION

This self-administrable 40-item QSF scale can measure and compare quality of sexual function for both genders. The scale was well accepted by the respondents. It is easy to answer and the evaluation is simple. Only a few results of reliability and validity have been established in this early stage of the development of the new instrument. Further research is needed to complete many missing aspects of reliability and the construct validity, particular its sensitivity to treatment effects.

The Aging Males' Symptoms scale (AMS) as outcome measure for treatment of androgen deficiency

INTRODUCTION

No clinical study data in which the AMS scale was applied as outcome measure has been reported until today.

METHOD

An open post-marketing study was performed by office-based urologists in Germany in 2000/01. We analysed data of 1174 androgen-deficient males who were treated with testosterone enanthate. The AMS scale was applied prior to and after 12 weeks treatment.

RESULTS

The improvement of complaints during treatment relative to the baseline score was 32% on average. Patients with little or no symptoms before therapy improved by 11%, those with mild complaints at entry by 24%, with moderate by 31%, and with severe symptoms by 39% compared with the baseline score. We showed that the distribution of complaints of testosterone-deficient men before therapy almost returned to norm values after 12 weeks of testosterone treatment. We also demonstrated that the AMS results can predict the independent (physician's) opinion about the individual treatment effect. The positive predictive value was 89%, the negative predictive value 59%, sensitivity (correct prediction of a positive assessment by the urologist) 96%, however, the specificity (correct prediction of a negative assessment by the physician) was only 30%.

CONCLUSION

The AMS scale showed a convincing ability to measure treatment effects on quality of life across the full range of severity of complaints. In addition, results of the scale can predict the subjective clinical expert opinion on the treatment efficiency.

The Aging Males' Symptoms (AMS) scale: review of its methodological characteristics

Background

The current paper reviews data from different sources to get a closer impression on the psychometric and other methodological characteristics of the Aging Males' Symptoms (AMS) scale gathered recently. The scale was designed and standardized as self-administered scale to (a) to assess symptoms of aging (independent from those which are disease-related) between groups of males under different conditions, (b) to evaluate the severity of symptoms over time, and (c) to measure changes pre- and post androgen replacement therapy. The scale is in widespread use (14 languages).

Method

Original data from different studies in many countries were centrally analysed to evaluate reliability and validity of the AMS.

Results

Reliability measures (consistency and test-retest stability) were found to be good across countries, although the sample size was sometimes small.

Validity: The internal structure of the AMS in healthy and androgen deficient males, and across countries was sufficiently similar to conclude that the scale really measures the same phenomenon. The sub-scores and total score correlations were high (0.8–0.9) but lower among the sub-scales (0.5–0.7). This however suggests that the subscales are not fully independent.

The comparison with other scales for aging males or screening instruments for androgen deficiency showed sufficiently good correlations, illustrating a good criterion-oriented validity. The same is true for the comparison with the generic quality-of-life scale SF36 where also high correlation coefficients have been shown.

Methodological analyses of a treatment study of symptomatic males with testosterone demonstrated the ability of the AMS scale to measure treatment effect, irrespective of the severity of complaints before therapy. It was also shown that the AMS result can predict the independently generated (physician's) opinion about the individual treatment effect.

Conclusion

The currently available methodological evidence points towards a high quality of the AMS scale to measure and to compare HRQoL of aging males over time or before/after treatment, it suggests a high reliability and high validity as far as the process of construct validation could be pressed ahead yet. But certainly more data will become available, particularly from ongoing clinical studies.