While the topic of female menopause is widely known and discussed, male menopause and the question of “Can men get menopause?” is less familiar to many people.
The word “menopause” means the stopping of menstruation, so of course men cannot have a menopause in the literal sense. But just as women experience a distinct decline in estrogen production leading to the end of their reproductive years, men also go through a gradual decrease in testosterone levels as they get older. This male hormonal shift, sometimes wrongly referred to as male menopause, is called “andropause” or “late-onset hypogonadism” and can result in a variety of physical and psychological changes.
Unlike the more abrupt and dramatic transition women go through with menopause, the hormonal changes in men tend to happen gradually over many years. The slow, drawn-out process means the symptoms of male menopause are often more subtle and spread out over time compared to the more distinct experience of female menopause.
Although male testosterone levels fall as men age, the decline is steady at about 1% a year from around the age of 30 to 40, and this is unlikely to cause any problems in itself in the majority of men. Some men, however will see a much steeper decline in testosterone levels.
Testosterone levels in men typically start to decline at around 1% a year from around the age of 30 to 40. By age 70, most men will have lost 20-50% of their youthful testosterone levels. This steady, long-term decrease in the primary male sex hormone is what gives rise to the condition known as male menopause or andropause.
At e-Surgery, our goal is to always inform our readers about conditions such as male menopause and other conditions which may face stigma.
Although the natural ageing process is the most common underlying cause, several other factors can contribute to or exacerbate male menopause symptoms. Identifying and addressing any of these additional contributing elements can be an important part of managing the changes men experience.
What Are the Signs of Male Menopause?
The primary symptoms associated with male menopause include:
- Decreased sex drive and libido
- Erectile dysfunction
- Fatigue and lack of energy
- Depressed mood, irritability, and mood swings
- Difficulty concentrating
- Increased body fat, particularly around the abdomen
- Reduced muscle mass and strength
- Osteoporosis and increased risk of bone fractures
- Hot flashes and night sweats
These changes are directly linked to the drop in testosterone production that occurs with ageing.
Testosterone is the primary male sex hormone responsible for the development of male sexual characteristics and maintaining a variety of bodily functions throughout a man’s life. When testosterone levels decline, it can have wide-ranging effects on a man’s physical and mental well-being.
In addition to the natural ageing process, there are several other factors that can contribute to or exacerbate male menopause symptoms:
Lifestyle Factors
Obesity, poor diet, lack of exercise, high-stress levels, and excessive alcohol consumption have all been shown to accelerate the decline of testosterone in men. Carrying extra weight, especially around the midsection, can disrupt the normal functioning of the endocrine system and lead to lower testosterone production.
Engaging in regular physical activity, particularly strength training, has been found to help boost testosterone levels.
Medical Conditions
Certain chronic illnesses like diabetes, thyroid disorders, HIV/AIDS, and some types of cancer can disrupt the normal testosterone production and metabolism in the body. The disease process itself, as well as the medications used to treat these conditions, can impact the hypothalamic-pituitary-gonadal axis that regulates hormone levels.
For example, type 2 diabetes is often accompanied by low testosterone male symptoms, which can contribute to low testosterone signs in males, such as sexual dysfunction, reduced muscle mass, and increased body fat. Addressing the underlying diabetes through lifestyle changes and medication can help mitigate some male menopause symptoms.
Medications
In addition to medications used to treat chronic diseases, certain prescription drugs can have the side effect of lowering testosterone levels. Opioid painkillers, antidepressants, and chemotherapy agents are among the medications that can disrupt the normal production and metabolism of testosterone.
Injury or Illness
Physical trauma to the testicles, as well as conditions that affect the pituitary gland or hypothalamus (which regulates testosterone production), can lead to a sudden drop in testosterone levels. This could be the result of an accident, surgery, radiation treatment, or a medical disorder affecting the endocrine system.
While the natural ageing process is the most common underlying cause, identifying and addressing any of these additional contributing factors can be an important part of managing male menopause symptoms.
Diagnosis & Testing
Unlike female menopause, which is typically diagnosed based on the cessation of menstrual periods, diagnosing male menopause requires laboratory testing to measure a man’s testosterone levels. This is done through a simple blood test that analyses testosterone concentration and other related hormones like luteinising hormone (LH) and follicle-stimulating hormone (FSH).
In general, doctors will look for total testosterone levels below 300 nanograms per deciliter (ng/dL) as an indicator of late-onset hypogonadism. However, because testosterone levels can fluctuate throughout the day, multiple blood tests may be needed to establish a consistent baseline.
Symptoms alone are not enough for a definitive diagnosis, as other medical conditions can cause similar issues with sexual function, energy levels, and mood. A comprehensive physical exam, review of medical history, and discussion of current symptoms are all part of the diagnostic process.
In some cases, additional testing may be ordered to rule out other underlying causes, such as:
- Thyroid function tests
- Prolactin level measurement
- Imaging scans of the pituitary gland
- Genetic testing for inherited hormonal disorders
The goal of the diagnostic workup is to distinguish true age-related testosterone decline from other potential causes in order to develop the most appropriate treatment plan.
It’s important to note that there is no single, clear-cut testosterone threshold that definitively diagnoses male menopause. Levels can vary widely between individual men, and symptoms may appear even in those with testosterone levels within the “normal” range.
Treatment Options
There are several different treatment approaches available for managing the symptoms of male menopause:
Testosterone Replacement Therapy (TRT)
This is the primary and most effective treatment option. TRT involves administering synthetic testosterone, either through injections, patches, gels, or implanted pellets. Products like Testogel sachets or Testogel Pump For Male TRT can help restore testosterone levels back to normal. The goal is to restore the testosterone levels to a more youthful, optimal range. This can help alleviate symptoms like low sex drive, erectile dysfunction, fatigue, and mood changes.
However, TRT is not recommended for all men, as it carries certain risks and potential side effects that need to be carefully weighed. These include acne, sleep apnea, enlarged prostate, and a potential increased risk of heart disease or prostate cancer in some men.
Lifestyle Changes
Adjusting diet, exercising, and managing stress can significantly impact testosterone levels and overall symptoms. Losing excess weight, engaging in strength training, getting sufficient sleep, and reducing alcohol intake are some of the lifestyle modifications that may help mitigate male menopause symptoms.
Weight loss, in particular, has been shown to be an effective way to boost testosterone in overweight or obese men. Since excess body fat, especially around the abdomen, is associated with lower testosterone production, shedding those extra pounds can help restore hormonal balance.
Medications
In addition to testosterone replacement, doctors may prescribe other medications to address specific symptoms. This could include drugs to improve sexual function, manage mood disorders, or maintain bone density. For example, medications like sildenafil (Viagra) or tadalafil (Cialis) may be used to treat erectile dysfunction.
Supplements
Over-the-counter supplements like vitamin D and zinc are sometimes used to try to boost testosterone levels naturally, though the evidence on their effectiveness is mixed. Nutritional deficiencies can contribute to low testosterone in young males and older males alike, so correcting those imbalances through targeted supplementation may provide some benefit. However, these should only be taken under the supervision of a healthcare provider, as high doses of certain male testosterone supplements can also carry risks.
The best treatment approach is highly individualised and depends on the severity of a man’s symptoms, overall health status, and personal preferences. Close monitoring and ongoing adjustment of the treatment plan are usually required, as the hormonal changes of male menopause are a lifelong process.
Conclusion
While the concept of “male menopause” may not be as widely known as its female counterpart, the reality is that most men will experience a gradual decline in testosterone production as they age. This hormonal shift can lead to a variety of physical and emotional changes that impact a man’s quality of life.
Recognising the symptoms of male menopause, understanding the underlying causes, and pursuing appropriate treatment are all important steps for men to maintain their health and well-being as they go through this natural transition. With the right medical guidance and lifestyle adjustments, the challenges of male menopause can be effectively managed.
Ultimately, greater awareness and open discussion around this topic can help destigmatise the experience of male hormonal changes and encourage more men to address their evolving health needs proactively. Just as women have learned to navigate the challenges of menopause, men too can take charge of their changing bodies and find ways to thrive during this phase of life.
If you believe that you may be suffering from low levels of testosterone or are looking for more information about menopause in men, do not hesitate to contact certified pharmacists at e-Surgery through our free Ask-a-Pharmacist service.
