Andropause is diagnosed based on a physical examination, the presence of symptoms and a blood test to check if the testosterone level is within normal range.

Three testosterone replacement preparations are commonly available in Singapore, says Dr Lee Fang Jann, Consultant at the Department of Urology at SGH. These are:

1. Testosterone gels

2. Testosterone gels are easy to use but come with some precautions. They must be applied every morning on the shoulders or upper arms. You must not bathe or swim for five hours after application to give the gel time to be absorbed.

   Take these precautions when applying testosterone gels:

   • Do not let anyone touch the testosterone gel on your skin. If women and children come in contact with the gel, they may experience side effects such as growth of new body hair in women and more aggressive behaviour in children.
   • Stay away from an open flame and do not smoke while applying the testosterone gel because it is flammable.
   • Wash your hands with soap and water after each application, and cover your shoulders or upper arms by wearing a short-sleeve shirt.
3. Testosterone pills

4. Testosterone pills are to be taken two to three times a day along with slightly greasy food to maximise absorption. Prolonged use of oral testosterone can raise cholesterol levels and increase the risk of heart and liver problems. This therapy is thus for short-term use only.

5. Testosterone injections

6. Testosterone injections are very convenient, but you may experience pain at the injection site. “The latest preparations require only one injection every three months. The absorption rate is very constant and there is no need for the patient to do anything in between the injections,” says Dr Lee.

Testosterone supplementation may cause rash, itching or irritation at the application site. Long-term side effects are unknown. Supplemental testosterone is not recommended for men with prostate cancer and an enlarged prostate as it may accelerate prostate tissue growth.

The SGH Urology Centre is seeing more men who are coming forward to discuss their andropause symptoms and seek treatment, says Dr Lee.

Ref: S13​