The Men in Menopause: What is Andropause?

Many look forward to retirement as a time to travel the world, spend time with loved ones, and truly enjoy the fruits of their labour. While there are definitely rewards of moving towards your retired years, the health complications that arise as one grows older are prevalent as well. In particular, women are experience physical signs that they are transitioning to the next stage in their life as they start to cope with hot flashes and sleepless nights. These uncomfortable symptoms are often a result of menopause – a normal part of aging for females that marks the end of their menstrual cycles. However, many do not consider the gradual hormonal changes that men experience as well — a less recognized transition known as “andropause”. 

What is andropause?

More commonly known as “male menopause”, andropause occurs when the body naturally begins to produce less of the primary male hormone, testosterone. This age-linked development often begins to appear in those who are 45 to 65 years old.  Andropause is often also associated with hypogonadism, a condition that causes a testosterone deficiency due to dysfunctional testicles. Therefore, both andropause and hypogonadism create similar symptoms among men, though the former is due to a physical impairment whereas the latter is naturally occurring.

Testosterone, predominantly secreted by the testicles, has many purposes for the male body and plays a role in the regulation of the following bodily functions:

  • Sperm production 
  • Muscle size and strength
  • Bone mass
  • Distribution of body fat
  • Red blood cell production

According to recent medical research, after the age of 30, testosterone levels drop by about 1% each year, and given its importance for body regulation, there can be consequences of this hormonal decline.

Symptoms :

As testosterone levels in the blood progressively decrease, the body lacks certain hormonal messages that cause subtle changes over time. However, it is important to note that these symptoms develop gradually and are not universal or prominent for all aging men. Some common signs of andropause include:

  • Loss of muscle mass
  • Decrease in bone density
  • Hot flashes
  • Moodiness, irritability, or depression
  • Build-up of fat around the abdomen and the chest
  • Difficulty completing strenuous physical tasks, such as running
  • Decreased sex drive (libido)
  • Erectile dysfunction

Causes and other risk factors :

As previously mentioned, andropause is a natural process that arises as testosterone levels decline with age. Nonetheless, certain behaviours may increase your susceptibility to developing the symptoms listed above. Those who cope with other medical conditions, such as type 2 diabetes, heart disease, and obesity are more likely to develop a more severe form of andropause that can further hinder a man’s overall lifestyle. In addition to these diagnosed health issues, sedentary habits, a poor diet as well as excessive substance consumption can all contribute to more rapid or grave development of andropause in men.

How to know if you are experiencing andropause :

Andropause is not an illness, but similar to menopause, a normal transitionary period as one becomes older. Even though there is no specific threshold that one must meet to be “diagnosed” with andropause, there are several ways that doctors may determine whether a man has an abnormally low level of testosterone. These tests include the Androgen Deficiency in Aging Men (ADAM) questionnaire that confirms common symptoms associated with a testosterone deficiency, as well as the Aging Male Symptoms (AMS) scale to determine the severity of such symptoms. These surveys are also often used to check for impaired functionality of one’s testes, also known as male hypogonadism. 

These questionnaires act as an initial screening process to indicate to your doctor that you require a blood test to accurately measure the specific testosterone levels that your body currently produces. It may also be necessary to conduct other medical tests to ensure that the symptoms you are experiencing are not a result of another undetected condition. 

Symptom management and treatment options :

To alleviate undesirable menopausal symptoms, many females seek hormone therapy to ultimately restore estrogen or progesterone levels in their bodies. On a similar note, men can undergo testosterone replacement therapy to manage the unwanted effects of andropause. In the form of gels, patches,  injections, and capsules [], most hormonal products must be prescribed by your doctor, though some pharmacies may offer over-the-counter options as well. Nevertheless, there are risks of receiving such treatment, including the possibility of aggravating underlying medical conditions as well as urinary tract blockage and prostate cancer.

Before going forward with hormonal therapy, it is often recommended to evaluate your lifestyle to determine whether your day-to-day decisions aid or rather worsen the side effects of a testosterone deficiency. Whether it be by introducing a balanced diet or avoiding additional sources of stress, these changes may act as sustainable solutions to the inconvenient consequences of aging.

Andropause vs. Menopause :

Many will oversimplify andropause as merely being a form of menopause in males. However, there are clear distinctions between these two transitional periods that should be recognized. 

Firstly, while hormonal changes are more sudden in women, andropause is a more gradual process and its effects manifest over a longer period of time. Additionally, menopausal women stop producing estrogen altogether, marking the end of their fertile years. On the other hand, while testosterone production diminishes, men remain fertile in their elderly. Thus, a shutdown of the reproductive system only occurs in females, and not men. Lastly, menopause is an inevitable developmental stage that all women will go through, whereas only about 45% to 60% of men will experience the consequences of andropause in their lifetime.

In all, both menopause and andropause are signs of a transitory time that signify wisdom, relaxation, but also weakening health. However, with the right information and support, the effects of both changes can be managed so that you can unpause and resume your long-awaited plans for retirement.