Andropause: Physical and Mental Symptoms and Treatment

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Updated April 03, 2016.

Andropause, also called "male menopause," is the time in a man's life when he starts to notice the effects of gradually falling levels of hormones. Although the hormones actually begin to decline much earlier, he may become aware of the decline during his late 40s or early 50s.

Some clinicians and researchers have questioned whether male menopause is more myth than reality, since it's not sudden, like menopause in women.

Still, as in women undergoing menopause, men experiencing a decline in hormones may suffer from symptoms of andropause. And as with menopause, symptoms of andropause can vary from person to person, and may range from minor to unbearable.

In men, testosterone (the "male" hormone) decreases gradually over time.

Studies show these declines start at around age 30 and continue at the rate of about 1% a year.

However, men experience the effects of this decline in different ways some may notice little change, while others may experience symptoms they find unpleasant or even intolerable.

In addition, although the decline in testosterone levels is gradual, some men may reach a point where they feel as if they suddenly have symptoms they didn't have before.

Symptoms of andropause can include: erectile dysfunction (failure to achieve an erection), decreased sexual desire, general tiredness, mood changes, problems sleeping, night sweats and sometimes palpitations. Men with lower levels of testosterone may see an increase in their body fat levels and a decrease in muscle strength and mass.

Decreased bone density also is possible.

In andropausal men, night sweats and heart palpitations can occur. This seems to happen because of falling testosterone levels.

Mood changes can take place, as well. Studies have shown that low testosterone levels are linked to a depressed mood in some men, and symptoms of nervousness and irritability seem to be relatively common.

Men experiencing andropause also may report memory loss, although this memory loss may be minor, and likely won't affect everyday functioning. Men also may experience a decline in self-confidence.

To diagnose andropause properly, your doctor may check for physical signs, including hair loss in the armpit and genital areas, and may order blood tests to determine levels of testosterone.

It may seem logical that you'd treat andropause simply by replacing testosterone, and in fact testosterone is a widely used treatment for what's called hypogonadism, a medical condition in which your sex glands don't produce enough hormones. One study showed that about 20% of men ages 60 to 70 had hypogonadism. This rose to 30% in men between 70 and 80 and 50% in men older than 80.

Still, many men with symptoms of andropause actually have normal testosterone levels. In these men, it's not as clear that the benefits of testosterone replacement therapy outweigh the risks.

Supplemental testosterone can help to increase muscle strength, bone strength and bone density. It also can improve sexual functioning and increase libido, and it may help to protect your heart and improve your mood.

However, there are some risks involved with taking testosterone replacement therapy. The therapy may contribute to sleep apnea, raise your risk for prostate enlargement, and even make your breasts grow. It also can raise your risks of pulmonary embolism, which occurs when a blood clot blocks the blood flow in one of your lungs.

And, although study results have been mixed on this, testosterone therapy may speed the development of prostate cancer for men at high risk for the condition, and it may worsen prostate cancer if you already have it.

If you're interested in treatment for your symptoms of andropause, talk to your doctor about getting your testosterone levels tested. Although testosterone replacement therapy has some benefits, most doctors don't recommend it for men whose hormone levels are normal for their ages.

You also can consider working to raise your testosterone levels naturally. Working out, especially with weights, and performing other strength training, can help, as can losing weight.

Sources:

Brawer MK. Testosterone Replacement in Men with Andropause: An Overview. Reviews in Urology. 2004; 6(Suppl 6): S9S15.

Gould DC et al. The male menopause: does it exist? Western Journal of Medicine. 2000 Aug; 173(2): 7678.

Osterberg EC et al. Risks of testosterone replacement therapy in men. Indian Journal of Urology. 2014 Jan-Mar; 30(1): 27.

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Andropause: Physical and Mental Symptoms and Treatment

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