DEAR DR. DONOHUE: Here’s one I bet you don’t see often. I am a male, 62, and recently have been getting night sweats, chills, sleeplessness and low-grade fevers. I read about testosterone supplementation, which I will not do. I am curious about male menopause. I have led a very active and physical life in a professional sport. Additionally, I had a vasectomy when I was 22. I am looking for a dietary, vitamin or homeopathic remedy for relief. — D.C.

ANSWER: Men don’t experience the sudden drop-off in testosterone production like women do in estrogen production at the time of their menopause. Further, male sperm production continues while women’s egg production stops at menopause. It is true that testosterone production lessens with age. Around age 40, its production decreases by 1 percent per year.

However, unlike women, relatively few men suffer any symptoms from this diminished production. Muscles do shrink with less testosterone around, and bones lose their strength. Sometimes erectile dysfunction is mentioned as a sign of testosterone deficiency.

If demonstrably low levels of testosterone are shown and men are having problems from muscle weakness or sexual performance, replacement therapy is a possible antidote.

I understand that you don’t want to take testosterone. I don’t think it would help you or rid you of your complaints. Night sweats, chills, sleeplessness and low-grade fever are not signs of a lack of testosterone. Those things can be signs of more serious conditions, like hidden infections and undetected cancers. You should submit to a thorough examination by your doctor. You should not try to self-medicate with vitamins, dietary changes or homeopathic remedies. You have to find out exactly what’s going on. Your vasectomy has nothing to do with any of your symptoms.

DEAR DR. DONOHUE: I am 59 and have erectile dysfunction. Is there another name for this “menopause?” Does it go away on its own? Pills from a vitamin store help me have an erection. — J.A.

ANSWER: Those who believe in a male menopause sometimes call it andropause or viropause. “Andro” is a Greek word for man; “vir,” a Latin word for it.

Erectile dysfunction comes from many different and unrelated conditions. Rarely is it the sole sign of testosterone lack. Thyroid disorders, plugging of arteries to the genitals, diabetes, depression, high blood pressure, high blood pressure medicines and obesity are the more common reasons for the inability to have an erection. ED doesn’t usually go away on its own.

Viagra, Levitra and Cialis have been revolutionary treatments for ED.

Even though your problem no longer is a concern, you ought to mention it to your doctor. The doctor can check you for artery plugging, which, if it exists in genital arteries, also could exist in heart arteries.

What is the name of the pill you’re taking? You have all male readers and me interested.

DEAR DR. DONOHUE: I misplaced an article you wrote about eye pupil inequality. Will you please repeat it? — D.A.

ANSWER: I wrote about Adie’s pupil, when one pupil is larger than the other. It usually happens to healthy young women. Infections, including syphilis and other conditions, cause the inequality, but they are in the minority.

Horner’s syndrome is another cause of difference in pupil size. Not only is one pupil smaller than the other, but facial sweating on the side of the smaller pupil stops. There’s a slight drooping of the eyelid over the eye with the smaller pupil. Most cases of Horner’s syndrome are idiopathic, meaning they have no discernible cause. One cause of this syndrome is lung cancer. Strokes can cause it, too.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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