Friday, May 23, 2008


Female menopause has been known about for centuries. However, until recently, a male version of the condition, called andropause, was considered a fairy tale. Doctors didn’t lend much credence to the concept. Although experts in the medical community still debate the existence of a comparable version of male menopause, there is a growing consensus that men do go through certain changes as they age.

What happens to men's hormones?

In the mid-to-late teens men get erections easily and can engage in sexual activity on multiple occasions in a short period of time. As a man ages, it can become more difficult to achieve (and maintain) an erection. There is also a longer time required between erections. Many physicians do recognize that this phenomenon is related to androgen (testosterone) decline. However, aging may not be the only cause of this. For example, certain illnesses such as diabetes can cause a man to produce less testosterone. 

Common symptoms of low testosterone and/or andropause

Some men do notice certain symptoms as they undergo androgen decline. These include:

  • fatigue,
  • weakness,
  • depression,
  • lack of motivation,
  • infertility,
  • decreased sexual desire,
  • loss of body and pubic hair,
  • small or shrinking testes,
  • height loss,
  • hot flashes and sweating,
  • and reduced muscle bulk and/or strength among others.

Sometimes, reduced androgen levels can lead to cognitive difficulties that can impact a man’s work performance. Some men will notice a decrease in their red blood cell count that could lead to anemia. Others report an increase in body fat, especially around the middle and struggle with reduced levels of self-confidence.

What are the causes andropause and/or low testosterone levels in men?

Of course, it’s important to note that many of these symptoms may not be caused by low testosterone levels at all and, in the majority of cases, are not the main factor for the symptoms. Thyroid dysfunction, liver disease, kidney failure and other illnesses can cause similar symptoms. Certain medications generate side effects such as depression, decreased sex drive and so forth. Lifestyle choices such as the usage of alcohol and/or drugs can create a variety of difficulties for men as they age so too can psychological conditions or emotional distress related to the aging process, aka the ‘mid-life crisis’.

The fact remains that, unlike women, men don’t have a specific stopping and starting point related to this process. Some men maintain normal hormone levels well into old age. Generally, males begin to reduce their testosterone production after the age of 40. This rate increases sharply between the ages of 45 and 50. However, most men don’t notice any difficulties with low androgen levels until they reach their 6th decade and only half of the men in their 80s currently report low testosterone levels.

Possible treatments for andropause

Not every man will develop the symptoms of andropause. Even fewer will get treated for the condition. A simple blood test can confirm whether a man’s testosterone levels are normal.  Treatment with Testosterone Replacement Therapy (TRT) is controversial. Studies are inconclusive about its merits and, in some cases, it has been found to increase a man’s chances of prostate cancer. Just like with Hormone Replacement Therapy (HRT) for women, long-term risk factors are not known. The treatment is still too new to determine what help, if any, TRT provides over time.

Some men find relief from their symptoms by incorporating the usage of herbs and supplements such as DHEA. A steroid hormone built by the body, Dehydroepiandosterone (DHEA) is a hormonal supplement that can be purchased over the counter. However, it’s best to work with a doctor to determine the appropriate levels as too much DHEA can be as problematic as too little.

The best treatment plan includes lifestyle changes. Eating a healthy, primarily whole foods diet with an emphasis on lean proteins, fresh vegetables and complex carbohydrates will go a long way towards keeping certain andropause symptoms at bay. Getting regular check-ups and discussing the results with a doctor are also wise choices to make as is talking to the doctor about any symptoms, especially those related to sexual dysfunction. Seeking help from a mental health professional may be in order. Talking out problems with a detached observer can make them better. Regular exercise can also increase the level of endorphins in the body and will make a man look and feel better well into old age.