Male menopause (“Andropause”) : Myth or reality?

Male menopause (“Andropause”) : Myth or reality?

After 30, testosterone levels decline by 1% yearly. Lower sex drive, mood swings and decrease in muscle mass are some of the changes experienced. 

Women typically experience hot flushes in their later years — but they aren’t the only ones. Aging men can also experience such symptoms, along with dwindling energy, osteoporosis, fading sex drive, among other myriads of problems. 

Over the years, doctors as well as the general public have embraced this slew of symptoms as ‘male menopause’ or ‘andropause’, a term used to describe the many changes that some men experience or undergo as they age.


What is male menopause/andropause?

Generally, this is a term used to describe age-related changes in testosterone levels. Male menopause involves a substantial decrease in testosterone production in males who are aged fifty and above.

It is also worth noting that the same cluster of symptoms is also referred to as androgen deficiency, testosterone deficiency, or late-onset hypogonadism

Testosterone is a hormone naturally produced in a man’s testes. It is a highly important hormone that serves the following functions: 

  • Fuels your sex drive 
  • Responsible for changes during puberty 
  • Fuels your physical and mental energy 
  • Controls your fight-or-flight response 
  • Maintains muscle mass 
  • Other important evolutionary features 

What triggers andropause?

Hormonal fluctuations are a normal part of the aging process. However, to some extent, female menopause is not the same as andropause. When females stop ovulating, they usually experience a significant drop in the level of hormones circulating in their system, and this happens in a somewhat shorter period. 

On the other hand, males usually experience a fairly slower and gradual drop in the level of testosterone circulating in their body, over the course of many years. This means that the effects on men, including changes in sexual function, mood, or even level of energy tend to remain subtle and unnoticed for years.

While testosterone varies significantly from one individual to another, generally older males tend to have lower levels of testosterone hormone compared to their younger counterparts. Testosterone levels usually decrease gradually throughout adult life, by approximately 1% annually after the age of 30. Around 70 years, a substantial drop of up to 50% may occur.

While a decline in testosterone levels is generally considered normal and results in very few symptoms, some cases might be considered pathological, requiring an immediate medical assessment to ascertain whether a medical condition is behind the decline in testosterone levels.


What are some of the potential effects of low testosterone?

Regardless of the cause, low or reduced testosterone levels can have a significant impact on your health, enhancing your risk for diabetes, osteoporosis, obesity, prostate disease, hypertension as well as COPD, among others. Testosterone impacts numerous things in your body — meaning if you fail to treat a low testosterone condition, you are likely to face a number of health problems ranging from bone density to heart issues.


What are the symptoms of low testosterone?

Some males with abnormally lower levels of testosterone display no symptoms of signs. However, in others, decreased levels of this essential hormone can potentially lead to one or more of the following symptoms:

  • Changes in overall sexual function, including lower libido, infertility, and few spontaneous erections. What’s more, a reduction in the size of the testicle is might occur.
  • Changes in sleep patterns, and you may experience insomnia.
  • Emotional changes that might manifest as decreased motivation, sadness, reduced self-confidence, depression as well as loss of memory and concentration.
  • Physical changes include an increase in body fat and a decrease in muscle mass, bone density, and strength. A decrease in endurance is also possible, as are lower energy levels and hot flushes.

However, it is also worth noting that some of these symptoms can be part and parcel of the normal aging process. They could also be caused by other health problems such as depression or even thyroid disorder. Your doctor will have to conduct a physical exam to help ascertain what’s behind your symptoms.


How do you fix low testosterone? 

There are numerous ways for those suffering from low testosterone levels to alleviate their so-called menopause symptoms. These include some simple and straightforward lifestyle, diet, and workout tweaks.

Exercise and strength training 

While extreme exercises such as marathon training have been proven to lower testosterone production, research shows that short, intense interval workouts such as cycling or running and even resistance weight training can help boost your testosterone levels.

Picture of an uncle doing exercise

Stress

Lowering your stress levels may also help keep your testosterone levels at optimum levels. If you didn’t know, increased levels of cortisol, a stress hormone, are associated with low testosterone. Luckily, engaging in stress-reducing activities such as meditation and exercise can be a great way to keep your T levels in check!

Diet

While there is no clinical evidence that suggests certain foods can enhance testosterone levels, generally we know that a healthy and balanced diet is key to good health. Incorporating whole foods into your diet routine and limiting refined and highly refined foods and drinks can help you to maintain a healthy weight and overall good health. 

Also, alcohol consumption directly reduces testosterone output — so that might be something you want to keep in mind. If you are unable to quit alcohol, at least try to minimise your intake and maintain a healthy diet as well as an exercise routine to keep your hormone levels balanced.


Is low testosterone or andropause treatable?

Yes, there are treatment options available for clinically low testosterone and one of them is testosterone therapy. However, both testing and subsequent diagnosis can be a bit tricky. This is simply because most of the symptoms associated with andropause can also be caused by other conditions and be experienced by individuals suffering from low testosterone levels.

Many aging men wonder if a boost in testosterone can potentially help them regain some of their youth. However, it is imperative to note that it is not recommended to reverse or rather ease the effects of the normal aging process, or to restore vitality, particularly because hormone replacement therapy could potentially result in adverse effects.

However, in certain instances though, testosterone therapy will make sense. For example, if you are an aged individual and are suffering from symptoms such as osteoporosis, depression, memory problems, or any other symptoms that are related to low levels of testosterone, your doctor may choose to measure the hormone levels in your blood and determine if you are a candidate for this type of treatment. If it is found that you are low on testosterone, testosterone therapy might help. The hormone can be administered as a gel that is rubbed into your skin, via a patch that attaches to your skin, or as an injection.

Some of the proven benefits associated with testosterone therapy include:

  • Increased muscle mass
  • Improved concentration
  • Memory
  • Energy levels
  • Libido

The bottom line

Male menopause or simply andropause remains a rather controversial topic of discussion. However, it is a fact that normal aging usually involves a gradual reduction in the levels of testosterone in most males. In some instances, this decline may be more prominent and may cause worrying symptoms. If you suspect that you may be suffering from symptoms of testosterone deficiency, it is high time you talk to your doctor and schedule an evaluation. While testosterone production might not be increased, there are many techniques to boost your sex life and overall wellbeing!


References

  1. Peate I. (2003). The male menopause: possible causes, symptoms and treatment. British journal of nursing (Mark Allen Publishing), 12(2), 80–84. https://doi.org/10.12968/bjon.2003.12.2.11056
  2. Mulligan, T., & Godschalk, M. (1998). Male menopause. Drugs of today (Barcelona, Spain : 1998), 34(5), 455–461. https://doi.org/10.1358/dot.1998.34.5.485244

This article was written and medically reviewed by Dr Ben, M.D on 03/09/21