The male (menopause) mystique

Want to experience serious information overload? Google “male menopause.”

Within seconds, you’ll be faced with reams of advice, from acupuncturists to news outlets. As you dig deeper, you might learn that male menopause is quite controversial. Commentators argue about every aspect of the condition, from what it is, to what to call it, to whether it exists at all.

So what is male menopause? And if it does exist, how can you tell if you have it?

Some people use the term “male menopause” to refer to hormonal changes that some men experience as they get older.

As men age, their testosterone levels tend to decrease. According to the Mayo Clinic, most men’s testosterone levels peak in adolescence and early adulthood. After age 30 or 40, those levels tend to decline by about 1 percent per year. By age 70, your testosterone level might reach closer to 50 percent of your peak level.

This hormonal shift can cause physical, emotional, and cognitive changes.

So why is there a controversy? In truth, male menopause differs substantially from female menopause. While female menopause is a natural part of aging, some older men never develop low testosterone beyond what is considered naturally acceptable.

Female menopause also sets in quite quickly, while “low T” can develop over decades.

According to the Endocrine Society, morning testosterone levels below 300 nanograms per deciliter (ng/dL) are typically considered low. Dr. Ciril Godec, chief urologist at Downstate Long Island College Hospital, notes that he’s “seen someone in his 80s with [a level of] 600 ng/dL, and… someone in his 30s with [a level of] 150 ng/dL.”

Due to these differences, many doctors prefer the terms “andropause,” “androgen deficiency of the aging male,” or “late-onset hypogonadism” to describe this condition.

By any name, low T can be troublesome. According to researchers in the International Journal of Clinical Practice, it can cause a variety of symptoms and complications.

For example, it’s been linked to reduced sex drive, erectile dysfunction (weaker erections), loss of muscle mass, increased fat accumulation, low bone mass, fatigue, sleep problems, and depression.

Testosterone plays a vital role in maintaining your sex drive and function. If your libido is lower than usual, it might be a sign of low T caused by andropause or another condition.

Low T can also lead to erectile dysfunction. This happens when you have trouble getting or maintaining an erection. It can also cause your sperm count to decline.

Testosterone helps regulate your mood. If your testosterone level drops, you might become depressed.

Common symptoms of depression include persistent feelings of sadness, emptiness, anxiety, irritability, or anger. You struggle to concentrate or remember things, lose interest in things you once enjoyed, or develop suicidal thoughts.

Those who are close to you may notice your depressed behavior before you even realize it. Depression due to any cause can be a hard thing to accept, and it may affect those around you.

In some cases, depression may be the first symptom of low T that you notice. In fact, Godec notes that “many men… in andropause go to psychiatrists” before they think to get their testosterone checked.

Testosterone helps your body maintain healthy energy levels. If you’re experiencing andropause, you might feel fatigued. You might struggle to find the energy to participate in your normal activities.

Low T can also contribute to sleep problems. Testosterone plays an important role in regulating your sleep patterns. If your testosterone level declines, you might experience insomnia and disturbed sleep.

Symptoms of insomnia include difficulty falling asleep and staying asleep. It can then lead to daytime sleepiness, trouble focusing, irritability, and being easily angered.

Testosterone helps your body maintain your bone density. If you develop andropause, your bones may become less dense. This can lead to osteoporosis, a condition in which your bones become brittle and fragile, fracturing more easily.

In many cases, osteoporosis doesn’t cause noticeable symptoms. You might not learn you have the condition until you sustain an unusual bone fracture or undergo a routine screening test. If your doctor suspects you have it, they may order a bone density test. They may also order a blood test to check your testosterone levels.

Excess abdominal fat can be both a cause and an effect of low testosterone.

Testosterone helps slow your body’s buildup of belly fat. If your testosterone level drops, you may accumulate more fat around your middle. In turn, an enzyme in your fat tissue converts testosterone to estrogen. This can cause your testosterone level to drop even more.

Other potential symptoms of andropause include:

  • breast enlargement
  • decreased motivation
  • decreased self-confidence
  • difficulty remembering things
  • increased nervousness
  • reduced muscle mass and strength
  • reduced body hair

If you notice any of these signs or symptoms, make an appointment with your doctor.

If you’re experiencing symptoms of low T or suspect you might be experiencing andropause, visit your doctor. They should be able to help you identify and address the cause of your symptoms.

To treat andropause, your doctor might recommend testosterone replacement therapy or other treatments.

Lifestyle changes may also help. According to Godec, “a healthy lifestyle is the best guarantor that your testosterone will remain at a healthy level as you age.” Make sure to exercise, eat a healthy diet, and maintain a healthy weight.