WHAT YOU SHOULD KNOW ABOUT MALE MENOPAUSE (ANDROPAUSE)

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 perimenopause and menopause. 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 healthy man may be able to make sperm well into his 80s or later.

Male menopause” is the more common term for andropause. It describes age-related changes in male hormone levels. The same group of symptoms is also known as testosterone deficiency, androgen deficiency, and late-onset hypogonadism.

If you’re a man, testosterone is a hormone produced in your testes. It does more than fuel your sex drive. It also fuels changes during puberty, fuels your mental and physical energy, maintains your muscle mass, regulates your fight-or-flight response, and regulates other key evolutionary features.

Male menopause differs from female menopause in several ways. For one thing, not all men experience it. For another, it doesn’t involve a complete shutdown of your reproductive organs. However, sexual complications may arise as a result of your lowered hormone levels. Men suffering from diabetes, high blood pressure or obesity were all more likely to have abnormally low testosterone levels. The reverse is also true: men with low testosterone levels are more likely to have or develop diabetes or obesity.

The drop in the male hormone occurs much more gradually, so it is less likely that men will experience a sudden onset of symptoms.

Here is what we know about testosterone levels in men:

  • Testosterone levels drop by about 1 percent every year after age 30.

  • By age 70, testosterone levels may be down by 50 percent.

  • Most men continue to make testosterone well into old age.

  • Other common causes of low testosterone include chronic illness, stress, alcohol abuse, and diabetes.

You may also experience swollen or tender breasts, decreased testicle size, loss of body hair, or hot flashes. Low levels of testosterone associated with male menopause have also been linked to osteoporosis. This is a condition where your bones become weak and brittle. These are rare symptoms. They typically affect men at the same age as women entering menopause.

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

Fatigue

It’s the middle of the day and you just can’t seem to get out of first gear. Is it lack of sleep, or could there be something else that makes you feel so wiped out?

Men gradually produce less testosterone as they age. Testosterone works hard in the body, maintaining everything from bone density to muscle mass to sex drive and beyond. A significant drop in testosterone levels can result in a reduced sex drive, increased body fat, decreased motivation, and sleep problems like insomnia. These symptoms can add up to chronic low energy and mental and physical fatigue. Everyone has phases of low energy when we just want to veg out on the couch. But prolonged mental and physical fatigue and chronic low energy can be a sign of serious health problems. Men have a unique set of reasons why they may experience fatigue for more than a few weeks at a time as men gradually produce less testosterone as they age.

 

Weakness

Men with low testosterone often lose their drive and initiative. Guys who used to be up and at ’em all day long are sidelined on the sofa.

Weakness and fatigue are terms that are often used as if they mean the same thing. But in fact they describe two different sensations. It is important to know exactly what you mean when you say “I feel weak” or “I am fatigued” because it can help you and your doctor narrow down the possible causes of your symptoms. Weakness is a lack of physical or muscle strength and the feeling that extra effort is required to move your arms, legs, or other muscles. If muscle weakness is the result of pain, the person may be able to make muscles work, but it will hurt.  Fatigue is a feeling of tiredness or exhaustion or a need to rest because of lack of energy or strength.

Depression

Depression is another of the major health problems that has been strongly linked to low testosterone levels. Like conditions such as diabetes and obesity, men with low testosterone have been found to be more likely to have or develop depression, and men with depression are more likely to have low testosterone levels.

One confusing factor is that some of the known effects of low testosterone are also symptoms, or can appear to be symptoms, of depression. When men have low levels of this important hormone they will often experience fatigue, increased irritability and a decreased sex drive. These symptoms are also common symptoms of depression. As people get older, their ability to absorb the serotonin that their bodies produce decreases. If low testosterone lowers serotonin levels, it may help to explain why low testosterone in older men seems to put them at particular risk for depression.

Symptoms that are common to both low testosterone and depression include:

  • irritability

  • anxiety

  • sadness

  • low sex drive

  • memory problems

  • trouble concentrating

  • sleep problems

The physical symptoms of low testosterone and depression, however, tend to be different. People who have depression but have normal hormone levels generally do not experience breast swelling and decreased muscle mass and strength that are associated with low testosterone.

The physical manifestations of depression are often centered around headaches and back pain.

If you or a loved one feels blue, irritable, or simply not yourself, make an appointment with your doctor. A physical exam and blood work can help determine if your testosterone levels are normal, or if you’re experiencing androgen deficiency.

Mood Swings

Mood swings in men are a primary symptom of andropause. Irritability as a result of a hormonal imbalance is a reality, especially for men between the ages of 40 and 60.

Irritable Man Syndrome or Irritable Male Syndrome (IMS) is the term used to describe the mood swings in men. Irritability in men is often a result of high stress cortisol levels and low testosterone levels. Some men respond by acting out while others hold these feelings in and become depressed. Behaviors characteristic of men with Irritable Men Syndrome include:

  • Angry

  • Impatient

  • Sarcastic

  • Anxious

  • Tense

  • Hostile

  • Argumentative

  • Unloving

  • Frustrated

  • Withdrawn

  • Demanding

  • Defensive

  • Sad

  • Dissatisfied

Although Irritable Male Syndrome is most often caused by high stress and/or low testosterone; high estrogen levels can also cause irritability in men. The main source of this imbalance is a declining level of testosterone associated with andropause and aging. Other factors can contribute to the andropause-related mood swings in men including weight gain. This creates fat cells which produce estrogen from testosterone. The higher the estrogen levels and the lower the testosterone levels, the greater the likelihood of irritability in men. Furthermore, high levels of the stress hormone cortisol diminishes testosterone levels, causing the same increased likelihood of mood swings in men. Certain medications can also cause hormonal imbalances.

Low Libido 

Sex hormones not only control us sexually, they also control how we look, feel, and even think. Testosterone plays a vital role in maintaining your sex drive and function. If your libido is lower than usual, it might be a sign of low testosterone caused by andropause (male menopause) or another condition. Low testosterone can also lead to erectile dysfunction. This happens when you have trouble getting or maintaining an erection. It can also cause your sperm count to decline. This hormonal imbalance can lead to a number of symptoms, one of which being a loss of libido. This is a very common symptom experienced by men going through andropause, and is sometimes a difficult one to talk about, as there tends to be a great amount of pressure on men to conform to the normal stereotype of having a high sex drive, and sometimes pre-conceived ideas that this is something that males do not experience issues with as much as women do.

 It’s normal for a man’s sex drive to slowly decline from its peak in his teens and 20s, but libido varies widely between men. What one man might consider a low sex drive, another might not. Also, sex drive changes within each man over time and is affected by stress, sleep, and opportunities for sex. For these reasons, defining a “normal” sex drive is next to impossible. Usually, the man himself identifies a lack of sex drive as a problem. Other times, his partner may consider it to be an issue.

Men normally experience a low libido due to a severe testosterone deficiency, which may also be accompanied by problems getting or maintaining an erection. More specifically, testosterone deficiency can happen when there is a signalling issue between the brain and testes, which can cause a drop in the amount of testosterone that is produced. It can be due to the brain sensing there is too much testosterone in the body, and signalling the testes to cut production. Another reason testosterone deficiency may occur is that the body simply can’t produce enough testosterone due to a defect in the testes.

Erection problems are usually caused by atherosclerosis — hardening of the arteries. If damaged, the tiny blood vessels supplying the penis can no longer dilate to bring in the strong flow needed for a firm erection. Diabetes, high blood pressure, smoking, and high cholesterol are the three main causes of atherosclerosis and erectile dysfunction. At the same time, low testosterone is a frequent accomplice to atherosclerosis in creating erectile dysfunction (ED). In studies, as many as one in three men mentioning ED to their doctor have low testosterone. Experts believe that in men with other factors causing erectile dysfunction, low testosterone can strongly contribute, making a difficult situation even worse.