Symptoms of andropause – Men’s health

Recommended by Dr. Michael White, Updated on November 25th, 2018

Symptoms of andropause can vary from one man to the next. Symptoms of male Andropause may include lethargy or decreased energy, decreased libido or interest in sex, erectile dysfunction with loss of erections, muscle weakness and aches, inability to sleep, hot flashes, night sweats, depression, infertility and thinning of bones or bone loss. When there is less testosterone available to do its work, the testosterone target-organ response decreases, bringing about many changes. Since there is great variability in testosterone levels among healthy men, therefore not all men will experience the same changes to the same extent.

Testosterone, together with its metabolites, is collectively known as androgens. As a group of steroid hormones, they stimulate the development of masculine characteristics and are responsible for male puberty characterized by deepening voice, broadening shoulders, and moustache growth. The hallmark of andropause is declining testosterone levels.

Testosterone levels begin to decline with age after maturation. This is accompanied by the concurrent appearance of a myriad of related physiological changes commonly associated with aging. These changes include diminished libido, reduced frequency of sex (the "senior slump"), erectile dysfunction, infertility, changes in body composition, reductions in body and facial hair, and osteoporosis. Andropause is in effect the reverse of puberty.

In addition, mood inventory scores indicate that during andropause, men report levels of anger, confusion, depression, and fatigue that are significantly higher than those reported by men with normal testosterone levels. The average human male begins to feel some symptoms of andropause after 40 to 45 years old, which is followed by rapid deterioration after the age of 50.

Many of the symptoms accompanying the andropause and the aging processes in men are similar to those of hypogonadism. We can attribute at least some of these symptoms to a decrease in testosterone levels, including:

Sexual Functions. Coital frequency declines rapidly with age from a mean maximal coital frequency of about 4 times per week at age 25, to once a week at age 50, 3 times a month at age 70, and 1.7 times a month between the ages of 75 and 79 years. Impotence also increases dramatically with age. It is rare before the age of 30. It is observed in 8 percent of people over 50 years old, 20 percent of those over 65 years old, close to 40 percent for those who are 70 years old. Body Composition. The amount of lean body mass in the sedentary person decreases by approximately 10 percent for every decade after the age of 30. You could have lost 30-40 percent of your lean body mass by age 60. Aging is accompanied by a decrease in lean body mass (LBM) and a concurrent significant increase in fat mass. Although aging itself is an important determinant of body composition, plasma total testosterone levels are not correlated to fat mass, regardless of age. The decrease of muscle mass is highly correlated to free testosterone levels, which persists after correction for age. Testosterone supplementation increases muscle mass.

Aging males, like hypogonadal men, accumulate preferentially visceral fat. This accumulation is a major cause of insulin resistance and the atherogenic lipid profile. This suggests that obesity in elderly men is a more important health hazard than in young men. Contrary to popular belief, clinical trials have shown that a low androgen status increases the risk of coronary artery disease (CAD) or atherosclerosis. It was previously believed that testosterone and other androgens had the opposite effect since men have higher rates of heart disease generally than women. Researchers now find that low androgen levels were associated with an increased incidence of CAD. Men with CAD had a 22 percent lower 'free androgen index'.

While decreased free and total testosterone levels can lead to increased fat mass, it could also be suggested that the decrease in testosterone levels in the aging male is the consequence of an increase in fat mass. In other words, there is a likely bi-directional relationship, the exact mechanism of which is still not fully known. Obesity is a multi-factorial disease that also includes genetic, social and psychological factors.

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Symptoms of andropause - Men's health

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