Male Menopause
What is the male menopause?
“Male menopause,” commonly referred to as andropause, describes an age-related reduction in testosterone levels in cisgender males. Signs of andropause include fatigue, insomnia, mood changes, and a potential impact on fertility. Andropause typically involves a decrease in testosterone production in men aged 50 or older and is often associated with hypogonadism. Both conditions involve lowered testosterone levels and exhibit similar symptoms. This symptom group is also known as testosterone deficiency, androgen deficiency, and late-onset hypogonadism.
Testosterone, a hormone produced in the testes, plays a vital role beyond just fueling sex drive. It drives changes during puberty, supports mental and physical energy, maintains muscle mass, and regulates the fight-or-flight response and other vital functions. Male menopause differs from female menopause in several key ways. It is unrelated to the menstrual cycle; not all men experience it. Additionally, it does not involve a complete shutdown of reproductive organs, though lowered hormone levels can lead to sexual complications.
What are the symptoms of male menopause?
Male menopause can lead to a variety of physical, sexual, and psychological problems, which often worsen with age. These issues can include:
- Low energy
- Decreased motivation
- Lowered self-confidence
- Depression or sadness
- Insomnia or difficulty sleeping
- Difficulty concentrating
- Reduced libido
- Increased body fat
- Loss of muscle mass and a sense of physical weakness
- Gynecomastia (development of breasts)
- Decreased bone density
- Erectile dysfunction
- Reduced libido
- Infertility
Additional symptoms may include breast swelling or tenderness, smaller testicles, hair loss, or hot flashes. Low testosterone levels linked to male menopause can also be connected to osteoporosis, a condition that weakens bones. These symptoms are uncommon and usually appear in men at the same age women experience menopause.
Changes in Testosterone Over the Years
Before puberty, testosterone levels are low. They increase as you reach sexual maturity, driving the typical changes of male puberty, such as:
- Growth of muscle mass and body hair
- Deepening of the voice
- Changes in sexual function
As you age, testosterone levels typically begin to decline.
How is male menopause diagnosed and treated?
Your doctor can test your testosterone levels with a blood sample. If male menopause is not causing severe hardship or significant disruption to your life, you will likely manage your symptoms without treatment. The biggest challenge in addressing male menopause may be discussing your symptoms with your doctor, as many men feel intimidated or shy about discussing sexual health topics.
The most common approach to managing symptoms of male menopause involves making healthier lifestyle choices. Your doctor might advise you to:
- Eat a healthy diet
- Get regular exercise
- Ensure adequate sleep
- Reduce stress
Should you be experiencing depression, antidepressants may be prescribed by your doctor. Therapy and lifestyle changes may also be recommended to help manage the condition. Testosterone therapy may be recommended, but its effectiveness is not fully established. This treatment might increase the risks of urinary tract blockage and prostate cancer and could potentially worsen conditions such as ischemic heart disease, epilepsy, and sleep apnea.
