When a woman has not had a menstrual cycle for 12 straight months, she is considered to have reached menopause. Bernadette Anderson, MD, MPH noted that this is a natural and permanent change in a woman’s reproductive cycle.
Do men go through their version of menopause?
“While there isn’t an exact equivalent in men, they experience a slow, steady decline in testosterone over time called andropause (or late-onset hypogonadism), which is often referred to as male menopause,” said Dr. Anderson. “According to the NIH, andropause is a ‘syndrome associated with a decrease in sexual satisfaction or a decline in a feeling of general well-being with low levels of testosterone in older men.’’’
Physical changes can include decreased muscle mass; increased body fat around the stomach; decreased bone density resulting in increased fractures; cognitive and energy level changes linked to difficulty concentrating, forgetfulness, and low energy; psychological aspects including depression, mood swings; anxiety; decreased libido; and erectile dysfunction.
Andropause is real, but this medical issue is arguably discussed far less than menopause. Dr. Anderson pointed out differences in this lesser recognized male health issue.
Changes in Testosterone
Dr. Anderson stated that testosterone does not drop off suddenly like estrogen does in women.
“Instead, it gradually starts in middle age (around age 40), falling about 1.6% each year. That said, most men still stay within the normal range—only 10% to 25% of men will have testosterone levels below the normal range,” she added.
The exact cause of andropause is not totally clear. However, underlying medical conditions can contribute to its symptoms. These include diabetes; high blood pressure; heart disease; obesity; metabolic syndrome; anxiety or depression; and stress.
“Lifestyle factors such as smoking, lack of exercise, and alcohol use may worsen the symptoms of andropause too. The good news? While you cannot completely prevent the condition, making healthier choices can help to manage its effects and, in some cases, reverse them,” said Dr. Anderson.
Andropause signs and symptoms
Unlike menopause, most men do not experience hot flashes with andropause, but common signs and symptoms are fatigue; depression; decreased sex drive; weight gain; erectile dysfunction; trouble concentrating; loss of muscle; and loss of body hair, according to Dr. Anderson.
She added, “Since these symptoms are not specific to andropause, it’s important to discuss them with your healthcare provider to rule out other potential causes.”
Dr. Anderson explained that in most cases, a primary care physician is the first point of contact for evaluation. They can order initial tests, including checking testosterone levels, and assessing other possible causes like thyroid disorders, diabetes, or depression.
“If the diagnosis is unclear, testosterone levels are significantly abnormal, or there are concerns about hormone-related conditions, a referral to an endocrinologist may be appropriate,” she said. “Along with a physical examination, your healthcare provider will typically order blood tests to measure testosterone levels—usually in the morning when levels are highest.”
Dr. Anderson added that additional lab tests may be done to check for underlying conditions that can mimic or contribute to andropause symptoms, such as diabetes; high blood pressure; thyroid disorders; pituitary gland tumors; and heart disease.
Andropause treatment
Treatment may be considered for men who have both low testosterone levels and symptoms that are affecting their quality of life.
“In such cases, testosterone replacement therapy (TRT) may be an option. TRT can be administered through skin gels, injections, patches, oral tablets, or implanted pellets. However, it’s not suitable for everyone,” said Dr. Anderson.
A history of certain medical conditions—such as prostate cancer, breast cancer, or uncontrolled heart failure—may make testosterone therapy unsafe, Dr. Anderson shared. This is the reason a thorough evaluation by a man’s healthcare provider is essential.
How to cope with an andropause diagnosis
Dr. Anderson noted that effective lifestyle habits can help men to feel better physically, mentally, and emotionally. She suggested that men should:
• Engage in Regular Physical Activity
Boost energy, maintain muscle mass, and support hormone balance by incorporating both strength training and cardiovascular exercise.
• Eat a Nutrient-Rich Diet
Men should fuel their bodies and stabilize their mood. Focus on consuming whole foods such as fruits, vegetables, lean proteins, healthy fats, and whole grains to accomplish these goals.
• Prioritize Sleep
Aim for seven to nine hours of quality sleep nightly.
• Practice Mental Wellness Techniques
Support emotional balance by utilizing stress-reducing strategies such as meditation, breathwork, or spending time in nature.
• Limit Alcohol and Quit Smoking
“Both can disrupt hormone levels and worsen symptoms,” said Dr. Anderson.Follow Dr. Anderson on Instagram https://www.instagram.com/drbernadettemd.