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Men: What’s
Normal, what’s Not, as You Age
Mayo
Clinic
September 10, 2002 Changes in the male body don't end after puberty. Most changes are perfectly normal, but some changes are cause for concern. It's important that you know the difference so you can seek treatment if necessary.
Body hair
The amount of body, facial and scalp hair you have can vary significantly over your lifetime. Genetics are the main determinate of your hair pattern and the amount of hair you have.
Male hormones (androgens) influence hair growth on some areas of your body while other areas respond very little. Androgen-dependent areas of your body hair include the pubic area, armpits, face, chest, abdomen and scalp. Some parts of your scalp may respond to androgen stimulation with hair loss while other areas respond with hair growth.
The finer hair on your arms and legs are less dependent on hormones. The degree to which an androgen-dependent area responds to hormonal changes is also genetically determined. For example, a friend may have a large amount of hair on his chest and abdomen while you have very little. Your friend's hormone levels are no higher, but his skin is genetically programmed to respond by growing hair.
Male hormone levels rise as your adrenal glands and testicles mature. Often this results in hair growth in your pubic and armpit areas and, with individual variation, hair growth on your face and body, and hair loss on your scalp.
These changes can continue through adulthood. It's not uncommon to continue to develop a thick beard or more body hair through your 30s, 40s and 50s. Similarly, scalp hair loss can begin in your teens and progress at varying rates through adulthood. Baldness typically begins with a regression of your hairline at the forehead and thinning at the crown of your head.
A significant decline in body, armpit and pubic hair — especially if associated with other signs and symptoms such as decreased libido, erectile dysfunction, fatigue, lightheadedness, breast enlargement or tenderness, or weight changes — may indicate a hormonal problem requiring a doctor's evaluation. But if you lose scalp hair in patches, see a dermatologist.
Body composition
As you age, your body becomes less muscular and body fat increases. In men, this extra fat is often deposited in the abdominal area. Gaining extra weight accentuates this and results in the spare tire of middle age.
This decrease in muscle mass and increase in fat is the result of several interacting factors. Muscle-building (anabolic) hormones tend to decline with age while muscle-wasting (catabolic) hormones stay constant or increase slightly. These hormonal changes along with diet, exercise and genetic predisposition interact to cause a change in your body composition.
Extra weight is unhealthy. This is particularly true if you have excess fat in your abdomen or upper body. The distribution of body fat in these areas is associated with an increased risk of heart disease.
An extreme form of changing body composition occurs in Cushing's disease. With this disease your body is exposed to chronic, very high levels of the catabolic hormone cortisol. Excess fat is deposited in your abdomen, neck and face while the muscles of your arms and legs waste. Easy bruising, stretch marks, swelling and an increased risk of diabetes and high blood pressure are associated with this syndrome.
Other conditions — such as liver disease, bowel disorders and abdominal tumors — can be associated with abdominal enlargement and shouldn't be confused with normal weight gain. If you put on weight around your middle and experience such signs and symptoms as pain, change in bowel habits, nausea or vomiting, jaundice, leg swelling, urinary problems or fatigue, see your doctor.
Scrotal masses
Scrotal masses — made up of fluid or solid material in, on or around a testicle — may be a sign of something as serious as testicular cancer or may indicate a less serious or harmless condition. Have your doctor check out any unusual lumps or swelling in your scrotal area. Scrotal masses can appear at any age but most commonly appear between the ages of 15 and 35.
Scrotal masses may be a sign of one of the following conditions:
Testicular cancer
Cancer of the testicle occurs most frequently in men and boys between 15 and 35 years of age. A cancerous lump occurs within the testicle rather than on the top or back. Have any such lump examined immediately. An ultrasound examination of the lump may help determine the cause of the lump.
Hydrocele
The most common swelling in the scrotum is an accumulation of fluid in the tissue that surrounds the testicle (hydrocele). Your doctor may shine a bright light through your scrotum (transillumination) to confirm the diagnosis. A hydrocele isn't serious but usually enlarges with time. It may cause discomfort and difficulties with the fit of your clothing. A minor operation can eliminate the sac and swelling. Just draining the fluid usually doesn't provide lasting relief.
Epididymis
The male organ that collects and delivers sperm is called the epididymis. This organ rests on the top and back of each testicle. If the epididymis is infected, it's called epididymitis. This condition produces a painful swelling that improves with antibiotic treatment.
The epididymis may enlarge slowly and without pain over a number of years due to a sperm cyst (spermatocele), which can be detected by a doctor's examination. If you've had a vasectomy, you may notice that the epididymis on each of your testicles is enlarged. This occurs because sperm continue to be produced, causing the swelling to increase until natural processes develop and balance sperm production and removal.
Inguinal hernia
A hernia in your lower abdomen or groin can extend into your scrotum and cause a swelling above your testicle. Your doctor can confirm a hernia by examining the opening above your scrotum, which contains blood vessels and the sperm duct (vas deferens), to see if anything has pushed through into the scrotum. A hernia often requires surgical repair.
Varicocele
Approximately 10 percent of men develop a varicocele. This is a collection of prominent (varicose) veins in the spermatic cord above your testicle. It's more common on the left side. A varicocele may occur in adolescence. Although a varicocele isn't dangerous, it may cause infertility.
A varicocele rarely causes pain, but swelling may increase after heavy lifting or exercise and decrease on lying down. Surgical treatment usually isn't necessary unless you have an infertility problem.
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