Male menopause? The first thing that you wonder when you hear this term is can a man experience menopause? Well, if research studies are to be believed, women are not the only ones who go through hormonal changes during old age. Even men experience low levels of hormones as they age. However, in some men, this decline may lead to low testosterone. This is the reason why many experts prefer to call the condition andropause or late-onset hypogonadism (LOH) or androgen deficiency in aging male (ADAM) instead of male menopause.
What is andropause?
Andropause is derived from Greek words in which “Andras” means human male and “pause” means cessation. Hence, andropause is defined as a condition which causes a decrease in sexual satisfaction or a decline in the generalized feeling of well-being due to testosterone deficiency.
What causes andropause?
In every man, the level of testosterone hormone tends to decline after the age of 25 and continues to decrease gradually till the rest of the life. The hormone levels decline at a rate of one percent per year with age.
The production of testosterone decreases as a function of age, however, this decrease is not universal. Moreover, the rate of decline in hormonal levels is different in different individuals. In most men, the gradual decline of the hormonal levels doesn’t seem to have any effect on their sexual performance. However, in some, it can lead to a drastic fall in sex drive or libido. The rate of decline is affected by chronic health problems such as obesity, illness, emotional stress, medication and poor lifestyles.
At what age does andropause begin?
Andropause can occur between 40-60 years of age. Sometimes, younger men may also experience andropause symptoms due to certain health issues.
What happens during andropause?
One of the reasons for a decline in the testosterone level with age is due to a reduction in the mass of Leydig cells present in the testicles. These cells play a key role in the production of androgen (testosterone) when stimulated by the luteinizing hormone (LH). It could also be due to a dysfunction in the pituitary and hypothalamic equilibrium that control the secretion of LH. This lead to abnormally low levels of LH, which in turn causes low testosterone production. Testosterone deficiency can affect the psychological, sexual, emotional, and physical well being.
Here are the common signs and symptoms of male menopause
Low sex drive: Testosterone plays an important role in maintaining your sex drive and function. Hence, low levels of this hormone can lead to loss of libido. Moreover, in the long run, it can also cause difficulty in achieving an erection, increasing the risk of erectile dysfunction. The diagnosis of late-onset hypogonadism is based on the symptoms associated with sexual health such as loss of libido, morning penile erection, and erectile dysfunction.
Depression: Studies have shown that depression can be associated with low concentrations of testosterone in older men. This is because testosterone helps to regulate mood.
Fatigue: It is one of the common symptoms of andropause which may occur due to low levels of testosterone or hypotestosteronemia. Testosterone is needed by the body to maintain energy levels and lack of energy leads to fatigue.
Abdominal obesity: Aging in men is associated with fat deposition in the central and upper body. This could be due to the decline in the concentration of growth hormones with age. These hormones also play a key role in the maintaining the levels of the sex hormone—binding globulin (SHBG) and testosterone. Hence, a decline in the growth hormones increases SHBG levels and causes testosterone deficiency with age.
As testosterone slows down the buildup of fat in the abdominal region, the deficiency of the hormone causes accumulation of belly fat.
Low bone density: A significant reduction in the testosterone levels in young men can accelerate bone loss and osteoporosis. In older men, normal levels of testosterone are needed to maintain bone mineral density, especially at the spine and hip region. Hence, low levels of testosterone in older men can increase the risk of hip fracture due to low bone mineral density.
Insomnia: Testosterone also helps to regulate sleep patterns. If the testosterone level reduces, it can lead to disturbed sleep and insomnia. And with age, this can further cause irritability, daytime sleepiness, and difficulty in staying asleep.
In addition to these symptoms, testosterone deficiency can lead to impaired cognitive function, reduced muscle mass and strength, and increased risk of cardiovascular complications.
How is andropause treated?
If the symtptoms of andropause are not affecting your day to day life and can be alleviated by adopting a healthy lifestyle with a nutritious diet, exercise, and proper sleep, then you may not require any treatment.
However, if you are experiencing any severe symptoms, then you must discuss the same with your doctor.
Studies have reported that testosterone replacement therapy (TRT) can help improve symptoms such as fatigue, decreased libido, and depression. The other benefits of TRT include:
-Improved body composition and muscle strength
-Improved bone mineral density
-Improved cognitive function
-Lowered risk of metabolic syndrome
-Improved mood, energy, and quality of life
Dr. Sanjay Kalra, Endocrinologist, Delhi, says, “Testosterone replacement therapy or supplementation is safe, provided it is prescribed to the right person, in the right dose, and administered in right manner, under supervision.” Testosterone is available as capsules, gels, short-acting injections and long-acting injections. Hence, if you are diagnosed with testosterone deficiency and are planning to undergo TRT, talk to your doctor about the potential benefits and risks associated with the treatment.
The article has been reviewed by Dr. Sanjay Kalra, Endocrinologist, Delhi.
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