The existence of a ‘male menopause’, or andropause (derived from ‘androgens’, the word for male sex hormones), remains controversial with some experts casting doubt on whether it is a real thing.1 However, whilst there is no simple definition of what it is, mounting evidence suggests that androgen/testosterone decline and deficiency not only exists but can have very real effects on the health, well-being, quality of life and relationships of many men – and the symptoms can potentially last years. Andropause does, however, differ significantly from menopause in women and this is where it can be difficult to make comparisons. Discover why and what you should know about the increasing body of evidence detailing how andropause can manifest itself and what you can do to manage it.
Unveiling andropause
Andropause is a term that refers to a group of symptoms experienced by men – typically in their late 40s to mid 50s – linked to a gradual decline in testosterone levels (and other hormones including the sleep hormone’ melatonin).2 Testosterone, a key hormone primarily produced in the testicles, is known to play a vital role in various bodily functions, including muscle mass maintenance, bone density regulation, sexual function, and stabilising mood.3 Some experts, however, argue that andropause may be more a response to the effects of lifestyle factors and psychological issues happening at this life stage. Diagnosing andropause is not helped by the fact that that men’s testosterone levels are not monitored routinely during health checks or that normal testosterone production varies widely in men and it is difficult to know when levels are of medical significance or not.
Age and testosterone dynamics
Research suggests that testosterone levels in men begin to decline gradually after the age of 30, decreasing at a rate of approximately 1%-2% per year.4 While some men may start experiencing symptoms of andropause in their 40s or 50s, others may not notice any significant changes or symptoms until later in life. Research also shows that married men and fathers tend to have slightly lower levels of testosterone than single men who do not have children – something thought to be the result of the stresses of family life and bringing up kids. Additionally, lifestyle factors, genetics, and overall general health can all influence the onset and progression of andropause symptoms. There is also emerging research suggesting that testosterone levels may be declining generation by generation.5, 6 It is unclear exactly why, but some have theorised it could be due to increasingly sedentary modern lifestyles, eating more ultra- processed foods, the rise in obesity and excessive and/or prolonged periods of stress. A study has shown men with healthier lifestyles tend to maintain more stable testosterone levels as they age.7/ Smoking, obesity and depression, on the other hand, have all been linked to lower testosterone levels.8
Acknowledging the differences
While andropause might share some similarities with female menopause, such as hormonal changes associated with aging, there are very specific differences between the two: for men there is no measurable point that signals andropause is happening or has happened (for women periods stop). Also, unlike menopause, which generally involves a sharp decline in oestrogen levels leading to more ‘defined’ and well-documented menopause symptoms, andropause entails a more gradual tapering off of testosterone levels and more subtle and nebulous symptoms. It’s probably not very obvious that andropause is happening as men may fail to recognise the symptoms and less likely to take action. It also in general does not signal the end of men’s reproductive years as menopause does for women.
In short, the only real comparison is that both menopause and andropause happen at roughly the same age, and that it involves a decline in hormone levels.
Symptoms of andropause
Men experiencing andropause may notice a range of symptoms9, including:
- lack of energy
- decreased libido
- erectile dysfunction
- fatigue
- mood swings
- reduced muscle mass
- increased body fat
- insomnia
- reduced motivation and drive
- memory problems
- irritability and grumpiness
These symptoms can vary in severity and onset from man to man, and some men might not notice them at all.
Raising awareness and understanding
While the term ‘male menopause’ remains contentious, there's ample evidence to support the existence of andropause and its related symptoms. However, it's important to recognise that andropause differs from menopause in women in terms of both hormonal dynamics and symptomatology. By raising awareness and understanding of andropause, men should feel more empowered to navigate this phase of life with confidence and seek appropriate support when needed. It can also help women to understand what men may be going through. Acknowledging the reality of andropause and promoting open dialogue surrounding men's hormonal health, can help not only raise awareness of the condition and its often life-affecting symptoms, but should also dismantle misconceptions and help men to embrace this natural phase of life with more resilience and understanding.
References:
- https://www.mayoclinic.org/healthy-lifestyle/mens-health/in-depth/male-menopause/art-20048056#:~:text=Debunking%20the%20male%20menopause%20myth&text=This%20is%20known%20as%20menopause,or%20age%2Drelated%20low%20testosterone.
- https://pubmed.ncbi.nlm.nih.gov/10687961/
- https://www.health.harvard.edu/staying-healthy/testosterone--what-it-does-and-doesnt-do
- https://www.nhs.uk/conditions/male-menopause/#:~:text=Although%20testosterone%20levels%20fall%20as,cause%20any%20problems%20in%20itself.
- https://www.reuters.com/article/idUSKIM169763/#:~:text=NEW%20YORK%20(Reuters%20Health)%20%2D,1%20percent%20a%20year%2C%20Dr.
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7063751/
- https://onlinelibrary.wiley.com/doi/10.1111/cen.14648
- https://www.sciencedaily.com/releases/2012/06/120623144944.htm
- https://www.baus.org.uk/patients/conditions/7/male_menopause_androgen_deficiency_in_the_ageing_male/
