Male menopause: is it real?

Men, as in women, also go through age-related hormonal changes leading to declining levels of testosterone (the equivalent of estrogens in women). The hormonal changes in men are however more gradual compared to menopausal changes in their women counterparts. The term ‘andropause’ has been coined to describe the age-related testosterone decline in men.

Men, unlike women will not experience a sudden noticeable bodily change. The defining menopausal change in women is the absence of monthly periods. Nothing similar in men though, the effects of declining testosterone levels may not be immediately apparent. On average, there is a 1 percent annual decline in testosterone levels from the age of 30, and by 70 years the levels have declined by as much as 50 percent. The consequent effects of low testosterone levels include low energy, mood changes, reduced libido, and sometimes erectile dysfunction. Such effects tend to be subtle and might go unnoticed for years.

Changes in male sexual function are more noticeable and distressing. Sexual desire declines over time, and spontaneous erections become fewer. Fertility potential declines as well, and in rare cases the testes also become smaller! Physical changes may also be noticeable and include reduced muscle bulk and increase in body fat; decrease in strength and endurance; lower bone mineral density and loss of body hair. Sleep disturbance creeps in as well, associated with emotional changes that include decreased motivation and self-drive, depression, and failing memory. All these changes are also part of normal ageing, and may also be caused by other disease conditions or medications. Hence a thorough medical assessment is usually warranted to exclude other conditions that may mimic andropause. Low testosterone levels can only be confirmed by a blood test.

Can men do anything to negate andropause creeping up on them? The straight answer is no, but certain lifestyle measures can help out. A healthy diet combined with physical activities maintains strength, energy and a lean body mass; not to mention improved mood and sleep patterns. Cigarette smoking, use of other illicit drugs and excess alcohol can make things worse. Avoid these if at all possible. And if symptoms are creeping up on you, better to seek medical help rather than wallow in self-pity.

Treating aging-related low testosterone with testosterone replacement medication is controversial. For some men, treatment with testosterone relieves bothersome effects of testosterone deficiency. For older men, treatment benefits with testosterone aren't clear, with potential risks of prostate cancer or other health problems. Testosterone treatment comes in the form of tablets or injections, which must always be prescribed by a specialist. Be wary of herbal supplements as well. Their safety profile in age-related treatment of low testosterone levels is unproven, and they could potentially predispose you to other health risks.

Quick facts• Men too go through ‘menopause’• Hormonal changes in men are more gradual