Andropause (Testosterone Deficiency Syndrome)

What??? You thought you were the only one!?!

Andropause or Testosterone Deficiency Syndrome is commonly called ‘male menopause’ and while some decline in testosterone levels is normal in aging, the early decline in younger adult men is concerning for their health and sense of wellbeing.

Women may not be the only ones who suffer the effects of changing hormones. Some doctors are noticing that men are reporting some of the same symptoms that women experience in peri-menopause and menopause.

The medical community is debating whether or not men really do go through a well-defined andropause. It has been shown in clinical practice that men receiving hormone therapy with testosterone have reported relief of some of the symptoms. Because men do not go through a well-defined period of change [as women do with the end of menstruation], some doctors refer to this problem as androgen (testosterone) decline in the aging male — or what some people call low testosterone. And while men do experience a decline in the production of the male hormone testosterone with aging, but this also occurs with conditions such as diabetes.

Along with the decline in testosterone, some men experience symptoms that include:

  • Fatigue
  • Weakness
  • Depression
  • Sexual problems

The relationship of these symptoms to decreased testosterone levels is still controversial.

Unlike menopause in women, when hormone production stops completely, testosterone decline in men is a slower process. The testes, unlike the ovaries, do not run out of the substance it needs to make testosterone. A man may be able to make sperm well into his 80s or later though there are concerns about the genetic package in the sperm of elderly men.

However, as a result of disease, subtle changes in the function of the testes may occur as early as age 45 to 50 and more dramatically after the age of 70 in some men.

Investigations are the Most Important part of this Care System

  • Detailed Bloodwork. Blood testing is the only way to diagnose a low testosterone level or a reduction in the bioavailability [functional level in the body] of testosterone.
  • Scrotal Ultrasound to rule out structural issues [testosterone is built in the testicles]
  • Investigations of other possible causes if not already done by the primary practitioner.

Some men have a lower than normal testosterone level without signs or symptoms. In this case, no treatment is needed. For others, low testosterone might cause:

  • Changes in sexual function. This might include erectile dysfunction, reduced sexual desire, fewer spontaneous erections — such as during sleep — and infertility. Your testes might become smaller as well.
  • Changes in sleep patterns. Sometimes low testosterone causes sleep disturbances, such as insomnia, or increased sleepiness.
  • Physical changes. Various physical changes are possible, including increased body fat; reduced muscle bulk and strength; and decreased bone density. Swollen or tender breasts (gynecomastia) and loss of body hair are possible. Rarely, you might experience hot flashes and have less energy.
  • Emotional changes. Low testosterone might contribute to a decrease in motivation or self-confidence. You might feel sad or depressed, or have trouble concentrating or remembering things.

However, some of these signs and symptoms can be caused by underlying factors other than low testosterone, including medication side effects, thyroid problems, depression and excessive alcohol use. There are also conditions, such as obstructive sleep apnea, that might affect testosterone levels. A full investigation by your general or nurse practitioner can rule these issues out or add to the information about your health. Often once these conditions are identified and treated, testosterone typically will return to normal.


Read more:

What You Can Do If You Are Concerned