How Much Do You Know About Andropause?

Andropause is a condition that affects men as they age. It is sometimes referred to as male menopause, and it can cause a wide variety of symptoms. Many men are not sure what Andropause is, or they do not understand the symptoms that come with it. In this article, we will discuss what Andropause is, the symptoms associated with it, and how you can treat it.

What is Andropause?

Andropause is also known as late-onset hypogonadism (or testosterone deficiency syndrome) in men. Andropause happens when a man starts to experience lowered levels of sex hormones (testosterone). This occurs when the testicles produce less testosterone than normal and can eventually lead to reduced male characteristics because of low levels of circulating testosterone. The decline begins after the age of 30 years old and accelerates between 50-70 years old, but it can happen earlier or later depending on genetics and lifestyle.

What symptoms does Andropause cause?

How does the body change? How does this affect a man’s everyday life, relationships, and self-esteem? The typical symptoms of testosterone deficiency syndrome (Andropause) can be categorized into three groups: physical, psychological, and sexual.  These include:

• Physical changes/symptoms: decreased muscle mass, increased body fat, fatigue, low energy levels, reduced endurance, and stamina. Some men also experience sleep problems with insomnia or frequent waking at night. **Other general symptoms include joint pains and stiffness from hormone imbalance affecting bone mineral density which makes them more prone to arthritis or osteoporosis with aging. There may also be a tendency for gynecomastia (enlargement of breast tissue), hot flushes due to sudden drops in the male hormones secreted by the testicles during the day or night time sweating as the body compensates for hormonal changes.
• Psychological symptoms: reduced motivation and drive, loss of focus, concentration or memory (‘fuzzy brain’), depression, mood swings, and irritability. Some may even experience a sense of worthlessness due to low self-esteem from an aging male syndrome which is associated with how a man feels about his physical appearance. How he perceives himself as sexually attractive with good mental strength, confidence and emotional control also have an impact on his relationships at home or work especially when it involves decision making or leadership in group settings.
• The emotional side can be very stressful because these men tend to withdraw socially due to feeling ‘less than adequate’ compared before so they isolate themselves more.
• Sexual symptoms: reduced libido (sex drive), erectile dysfunction, difficulty in achieving or maintaining an erection, premature ejaculation, and reduced semen volume. In severe cases, some men may also experience a decline in fertility due to low sperm count.

The severity of these symptoms will vary from man to man and it is important to see a doctor if you are experiencing any changes so that they can be assessed and the best treatment plan can be put into place. Testosterone replacement therapy (TRT) is often recommended for symptomatic relief but there are potential risks associated with long-term usage so always seek medical advice before starting on this type of treatment. It’s better to prevent Andropause from happening in the first place by following healthy lifestyle habits which include maintaining a balanced diet, exercising regularly, and getting plenty of good quality sleep!

Andropause diagnosis and treatment

The symptoms of andropause are not specific to this condition. The diagnosis is based on a thorough clinical history taking, physical examination, laboratory studies, and other investigations such as pelvic ultrasound scans or prostate biopsy. Laboratory tests include the following:

• Serum testosterone level: it should be taken early in the morning when possible as this reflects the peak level for that day. A low serum (blood) testosterone level is indicative of hypogonadism but does not exclude normal aging with age-related decline in serum testosterone levels known as partial androgen deficiency of aging males (PADAM). PADAM patients have an average reduction in their total serum testosterone by about 40% at 80 years old compared to 20-year-olds without having any symptoms.
• SHBG (sex hormone-binding globulin) level which is elevated in older men and can bind up to 98% of available testosterone making it unavailable for biological activity; a low SHBG indicates more bioavailable testosterone.
• Estradiol levels are generally increased with age and may help differentiate between andropause and other causes of hypogonadism.
• FSH (follicle-stimulating hormone) and LH (luteinizing hormone) levels: help to determine the functional status of the ovaries or testes. An increase in FSH and LH levels suggests primary ovarian failure or primary testicular failure, while a decrease suggests secondary gonadal failure due to pituitary dysfunction.
• Prostate-specific antigen (PSA) level: this is a protein produced by the prostate gland and high levels may indicate enlargement of the gland, infection, or even cancer but it can also be elevated in other conditions. The PSA test should not be used to screen for prostate cancer.