The Truth About Andropause

“One thing that comes to our mind when it comes to the male menopause: Is it real? Or is it just fantasy?”

Acknowledged by health professionals as a natural stage in a man’s life, andropause—also known as the male menopause—is a collection of symptoms attributed to a gradual decline in testosterone levels. Yes, it seems that it is not only women who suffer the effects of changing hormones due to aging, as doctors around the world have long noticed men reporting some of the same symptoms experienced by women at the onset of perimenopause and menopause.

Now, the female menopause basically marks the end of a woman’s reproductive years. But men, too, may experience changes in their bodies as they reach their late forties and early fifties. So, there is a long-standing anxiety among the populace about what to expect at that age and whether males will go through something like the female menopause.

To be fair, there is still some debate—even within the medical community—of what really constitutes menopause, especially for men. The problem of defining the male menopause is compounded by how it is sometimes simply referred to as a decline in testosterone in aging males. And some doctors simply call it “low testosterone” and end their diagnosis there.

Truth be told, menopause in women is much easier to define: It happens when the production of reproductive hormones stops completely. In men, the decline in testosterone is a much slower process and can also occur as an effect of other medical conditions such as diabetes. The overall effect, however, has been well-observed and includes everything from increased fatigue, sexual problems (a reduction in libido or sex drive and erectile dysfunction), weight gain as well as emotional symptoms which may be similar to the changes experienced by women.

The Importance of Testosterone

If there’s one thing that everybody can agree on, it’s that testosterone is an essential hormone for life. Made naturally by the body, it plays an important role in the growth of male reproductive organs such as the testes and the prostate gland. It’s also responsible for lean, healthy muscle mass, the growth of body hair, maintaining bone density, cultivating mental alertness and ensuring a powerful immune system.

There are also several lesser-known benefits of testosterone, including the prevention of osteoporosis and maintaining the overall health of the heart. Add to that fat distribution and production of red blood cells. That’s why testosterone levels also dictate your overall fitness level: When the body has healthy levels of testosterone you feel strong and when it’s is low, you feel weak

Finally, on top of all that, testosterone is the driving force behind a man’s sex drive and is critical for sperm production. It is, put simply, the most important male hormone.


Signs of Low Testosterone

One of the most noticeable symptoms of low testosterone is an increase in body fat, which becomes hard to get rid of no matter how hard you exercise. Sometimes, this also means having little to no muscle definition as muscle strength drops dramatically. Activities that were once easy now become really difficult, exhausting while regular exercise wears you out far beyond the way it usually does.

Along with that, regular mental fatigue might pop up as well, as though the mind refuses to function properly. Concentration becomes difficult and memory fades. There is also a change in sex drive: Spontaneous erections don’t happen as often, the urge to have sex declines rapidly and sperm count drops. There’s a loss of motivation, as though nothing matters. It’s more than likely that self-confidence will drop, too.

If anything, this bleak list of symptoms reinforce the notion that testosterone is critical for men.


How Is Andropause Diagnosed? 

First of all, the first step to take when andropause becomes a concern is to consult with a doctor. Of course, any diagnosis will be based on a very thorough review of your health and list of symptoms. A blood test will be done to get a detailed review of your testosterone levels and connected hormone measures. There will also be further tests covering a wider array of health measures such as prostate inflammation, liver and kidney function, red and white blood cell count and blood fat. Then, after everything has been sorted out, your doctor will review your symptoms, your medical history and will also conduct a physical examination. Once the result is out, what follows is putting together a plan with your doctor to address any health issues that have been discovered. In a way, this is pretty much the same thing that would—and should—be done for any possible health problem.

Treatment Options

Fortunately, a wide range of andropause treatment strategies are available to help men deal with the unpleasant symptoms of the phase. The most popular option are testosterone preparations including hormone injections, testosterone patches (androderm), testosterone gels (androgel) and testosterone pellets (testopel).

A word of warning, however: While many of the potential adverse effects of testosterone are universal for all of the preparations, different formulations sometimes provide different benefits and side effects. Testosterone replacement therapy has been linked to heart disease and prostate problems. Other experts also emphasize that the benefits and risks of long-term testosterone therapy are unknown. Unfortunately, large clinical trials for these kinds of treatments have not been done yet.

Just like hormone replacement therapy in women, testosterone replacement therapy comes with a laundry list of potential risks and side effects. Reports suggest that replacing testosterone may worsen prostate cancer. If you are considering hormone replacement therapy, talk to a doctor to learn more about its pros and cons. Your doctor may also recommend certain lifestyle changes to help with some symptoms of male menopause.

For alternatives, the male menopause can be treated through a variety of modalities including:


  • Lifestyle Changes

It’s possible that the symptoms you’re experiencing can be relieved through simple lifestyle changes. Although it’s always advisable to live a lifestyle that includes fresh air, water, sunshine, exercise, and sleep, your lifestyle choices become even more important when health issues arise. On this note, it can be quite helpful to enlist the guidance of a functional medicine practitioner to see if any specific changes can or should be made, or if there are other treatment options that you might want to consider depending on your specific condition.


  • Increase Exercise 

By increasing your activity levels, your body will get the message that it needs to produce more hormones to maintain muscle and bone mass. Exercise has also been proven to reduce stress. Stress increases your cortisol levels which negatively impacts sex hormone production. Don’t overdo it, however, as some forms of exercise can actually be counter productive. Continual endurance training has been linked with lower testosterone levels.


  • Eat Healthy

When it comes to the dietary approach to dealing with andropause symptoms, it’s not just about eating fruits and vegetables. There are, in fact, a number of specific food items that encourage the production of specific hormones. Key nutrients that promote healthy testosterone levels are vitamin D and zinc.


  • Relaxation Therapy

Relaxation isn’t only about peace of mind; it’s a process that decreases the effects of stress on your mind and body. Relaxation therapy can definitely help you cope with the symptoms of andropause. To get the most of it, use relaxation techniques along with other positive coping methods, such as thinking positively, finding humor, problem-solving, managing time, exercising, getting enough sleep and reaching out to supportive family and friends.

  • Psychotherapeutic Support

Psychotherapy (sometimes called “talk therapy”) refers to a variety of treatment techniques that aim to help a person identify and change troubling emotions, thoughts and behavior. It can be an alternative to medication, but is best used in conjunction with  other treatment options as part of a comprehensive solution.


  • Couples and Family Therapy

Obviously, the onset of andropause, can be traumatic to both men and their families. It is not the kind of subject that is often brought up in conversation among men. Most men are easily embarrassed by these symptoms and, when asked by a spouse or significant other, will often deflect the questions with nebulous comments about stress or simply a need to gather one’s thoughts. Or even the classic “it’s not you, it’s me.” It needs to be pointed out, however, that in the case of the male menopause, the truth will set you free.


Final Thoughts

Like most hormone-related conditions, the male menopause does not affect all men the same way. As a general rule, most men will not feel the same intensity of symptoms that might plague others. On the other hand, although the severity of these andropause symptoms may vary, the inevitability of aging and the decline of youth will have its impact on all men.

All that being said, the term “male menopause”  or “andropause” still represents a set of symptoms that is not as well-defined as it should be. As the symptoms generally associated with the male menopause are mainly caused by low testosterone, a wide range of diseases, mental health issues, obesity and other lifestyle components can become underlying factors that might hinder a definite diagnosis.

However, studies have shown that men are often reluctant to admit, even to themselves, when they need help dealing with menopause-like symptoms, even as the subtle changes due to hormone decline become readily apparent. Further compounding the problem is evidence which suggests that testosterone deficiency has been over-diagnosed in ageing men. Not only that, the symptoms of testosterone deficiency may occur alongside other health conditions and often occur in ageing men who do not have testosterone deficiency. Thus, a diagnosis cannot be made on evidence of clinical symptoms alone and must involve lab-work. Finally, determining what constitutes normal testosterone levels is a huge problem in its own right.

All that being said, one of the major hurdles in facing the male menopause comes from within. It’s not easy to gracefully transition from early adulthood to maturity, to change one’s perception of invincibility as age bring vulnerability. Fortunately, we do not need to fear all this. We still have control over it and with the right information and support, the male menopause becomes manageable. And as always, the sooner we reach out for help and support, the better off we will be.