Irritable Male Syndrome


What is Irritable Male Syndrome?

The irritable male syndrome represents a behavioural state that is followed by nervousness, irritability, lethargy and depressive symptoms. It is present in adult male population upon the decrease in testosterone levels. Such condition is followed by the presence of the negative mood state and it occurs at the end of the mating season.

The most prominent symptoms are anger and social withdrawal. The symptom is frequent in male population in a lifetime period between the age of 40 and 60.

Irritable Male Syndrome picture 1


Andropause represents the impaired physical ,emotional, psychological and behavioral patterns due to physiological aging process. It may as well be associated with late onset hypogonadism, male climacterium, decreased testosterone and androgen concentrations.

The aforementioned syndrome is caused due to the increased levels of cortisol and decreased levels of testosterone.

It has been postulated that progressive decrease in T secretion induces the onset of irritable male syndrome.

There have been found expressed androgen and estrogen receptors in cells in the region of the preoptic region as well as ventromedial. The melatonin receptors are present in the premammillary region that displays the effects of melatonin functioning in certain day periods.

There are involved other receptors as well such as opioidergic, dopaminergic and serotonergic.


Irritable male syndrome is linked with the lower hypothalamic amine concentrations.

Certain decrease in the level of opioid peptides is present as well.

Nowadays, stress represents an everyday characteristic in a man’s life. It is gradually increasing as well. (1)

Irritable male syndrome is a complex syndrome that has impact on hormonal, physical, psychological, emotional, social, sexual and spiritual spheres of the human life.

Etiopathogenesis

In majority of man, the irritable male syndrome is caused by stress.

It may be as well due to an impaired testosterone and estrogen levels.

Testosterone C19H28O2

In male population, in the phase of andropause or physiological aging process, such condition is more prevalent.

In obese males, fatty cells that convert testosterone to estrogen may represent an additional cause. (2)

Hence, increased concentration of cortisol decreases testosterone levels. Such state may lead to change in men’s behaviour.

There are several medicaments that may cause hormone disbalance.

Testosterone

Testosterone is a hormone in the reproductive tract that has a major role in the reproductive tissue and the central nervous system.

In male population, its impaired levels are linked with the onset of depressive symptoms.

In hypogonadism, there is decreased testosterone level is present. It is in correlation with the onset of depressive symptoms.

Irritable Male Syndrome Flow Chart 2

It is postulated that men’s body secretes 4 to 7 mg of testosterone daily. Such production is expressed in circadian rhythm. It is known that the maximal plasma concentration of testosterone is in the morning. Thus, its level decline during the night period.

Signs & Symptoms

The most prominent symptoms of irritable male syndrome is sadness, frustration , worry and tension followed by aggressiveness.

Irritable Male Syndrome Symptoms
Irritable male syndrome is defined as the presence of impaired hormone levels, physiological, and biochemical changes that occur in all men.

Such impairment modulates the hormonal, physical, psychological, social, sexual and nutritional aspects of men’s health.

Stress may be the most frequent causative agent. Thus, such effect is especially evident if in synergistic effect with hormonal changes in male individual.
This syndrome is characterized by hypersensitivity, anxiety, frustration and anger.

It is associated with certain biochemical changes, hormonal impairment, stress and loss of male identity.

Additional symptoms in irritable male syndrome are mood changes, lack of libido, hot flashes, headache, sarcasm, frustration, defensive behaviour.

The initial symptoms the hypersensitivity. It is not recognized in the vast majority of man population.

Afterwards, anxiety is present. It represents a condition associated with uncertainity, fear caused by the anticipation of a real health issue.

Irritable man syndrome is followed by the presence of constant fear as well as other difficulties such as professional difficulties, sexual impairment and interpersonal problems.

There is frustration as the next symptom. It is a feeling that is associated with an experience of the inability to fulfil an individual’s personal goals.

Most commonly, they are not aware of the potential arising problems.

In some man, there is a sense as the are making an effort to organize their everday activities.

In social relationships, most commonly there is a sense of frustration.

It may lead to suicide in certain individuals.

Ocassionally, described mood impairment could be evident, or in certain individuals subtle.

Individual may express hateful words, actions or suffer in silent mode.

Diagnosis & Treatment

The individuals with the irritable male syndrome, most commonly are not fully aware of it.

Further evaluation of hormone levels, nutritional profile and physical activity via individualized programs is recommended.

As far as additional investigations, the levels of salivary and serum testosterone should be obtained.

In addition to the testosterone evaluation, it is advisable to obtain levels of DHES, FSH, and estradiol.

Such testing should be performed in the time period from 8:00 to 9:00 in the morning.

The therapeutic approach may consists of testosterone replacement in selected cases.

Testosterone replacement should in theory approximate the natural (endogenous) production of the hormone (via intramuscular or topical route).


References

  1. Lincoln GA. The irritable male syndrome.Reprod Fertil Dev. 2001;13(7-8):567-76.
  2. Hileman SM, Jackson GL.Regulation of gonadotrophin-releasing hormone secretion by testosterone in male sheep.J Reprod Fertil Suppl. 1999;54:231-42.
  3. Stephanie Rodgers.Serum testosterone levels and symptom-based depression subtypes in men. Front. Psychiatry, 04 May 2015

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