Andropause, also known as male menopause, is a condition that affects all men as they age and is a natural occurrence in a man’s lifecycle, similar to menopause in women.
All women will eventually go through menopause — in the same way, all men will go through andropause at some point in their lives.
Andropause refers to the gradual decline of testosterone levels in men, typically occurring between the ages of 40 and 55 — however, it’s possible for testosterone levels to begin declining as early as your 20s.
The big difference between menopause and andropause is that menopause is a sudden drop in hormone levels whereas andropause is much more gradual, sometimes as little as 1% a year.
Testosterone is a crucial hormone responsible for maintaining various bodily functions, including sexual health, muscle mass, bone density, and mood regulation. When levels drop, you can experience a wide variety of unpleasant symptoms.
Symptoms of Andropause
The symptoms of andropause can be both physical and psychological. Physical symptoms may include:
- Fatigue
- Decreased muscle mass
- Weight gain
- Erectile dysfunction
- Decreased libido
Psychological symptoms include:
- Irritability
- Depression
- Anxiety
- Difficulty concentrating (brain fog)
- Decreased sense of well-being
The severity of symptoms can vary from person to person. Some people will find that they don’t even notice symptoms at all despite their levels being significantly lower than they were when they were young.
For others, the symptoms can be so severe that they make life nearly impossible. These symptoms can significantly impact a man's quality of life, relationships, and overall happiness.
Recognizing these symptoms is crucial in seeking proper treatment and support. Unfortunately, there are still many in the medical community who do not take andropause — or low testosterone in general — seriously.
This is because there’s a mistaken belief that as long as your levels fall within the acceptable range — 300 ng/dL to 1000 ng/dL for total testosterone — you won’t experience any symptoms. That’s just not true, mostly because all men have different baselines.
If what was “normal” for you was around 700 ng/dL when you were in your 20s, you could feel significant symptoms by falling to 400 ng/dL, despite this still being in the “normal range.” Your symptoms are much more important than the numbers involved.
The Cause of Andropause and Common Causes of Low T
The primary cause of andropause is the natural aging process — when this process progresses far enough, you’re considered to have Low T.
However, Low T has other potential causes that make this natural process much worse, and there are other factors that can contribute to the onset of andropause or exacerbate its symptoms.
These include:
- Diabetes
- Obesity
- Metabolic syndrome
- Certain medications (opioids, antidepressants)
- High-stress levels
- Poor diet
- Lack of exercise
If you are dealing with any of these issues, they’re probably making your symptoms worse. On top of this, there are other conditions that will directly cause Low T no matter what your age is, including:
- Klinefelter syndrome
- Noonan syndrome
- Damaged testicles
- Testicle removal (usually because of cancer)
- Chemotherapy
- Radiation therapy
- Pituitary gland disease
- Infections
- Autoimmune disorders
- HIV/AIDS
Regardless of the cause, the first step is identifying your symptoms and then getting to a medical provider so you can have your levels tested.
Diagnosing Andropause
To diagnose andropause, healthcare professionals may conduct a series of tests to assess hormone levels and evaluate symptoms. The most common test used is a blood test to measure testosterone levels.
Additionally, a comprehensive evaluation of symptoms, medical history, and a physical examination is necessary to determine if andropause is the underlying cause of the symptoms.
Seeking medical advice and undergoing the appropriate tests is essential to receive an accurate diagnosis and develop an effective treatment plan.
It’s also important for insurance purposes — even if you’re experiencing symptoms, some insurance providers won’t pay for treatment unless you’ve had your hormone levels checked and they have been confirmed to be low.
Treatment Methods
There are various treatment methods available to manage andropause symptoms effectively. For most men, treatment is fairly straightforward, isn’t very burdensome, and is usually very effective.
These treatment options range from lifestyle changes to testosterone replacement therapy (TRT), though TRT is the simplest and easiest treatment option.
The reality is that, for most people, changing their lifestyle is very hard, if not impossible. TRT tends to be more effective because it’s a simple medication to take.
However, medication isn’t right for everyone. The right treatment approach for you will vary depending on your individual symptoms, medical history, and preferences.
Consulting with a healthcare professional is crucial in determining the most appropriate treatment method for your specific needs.
One reason men might decide to focus on lifestyle changes and not TRT is because TRT can make men infertile. If you plan on having children in the future, you may want to try to figure out how you can change your lifestyle so that you don’t have to go on TRT.
Lifestyle Changes to Manage Andropause Symptoms
Implementing certain lifestyle changes can significantly alleviate andropause symptoms. Regular exercise, particularly strength training, can help maintain muscle mass and improve overall physical well-being.
A balanced diet rich in essential nutrients is also beneficial in supporting hormone production and overall health.
Additionally, stress management techniques such as meditation, yoga, and relaxation exercises can help reduce the anxiety, irritability, and depression associated with andropause.
How Testosterone Replacement Therapy Works
Testosterone replacement therapy (TRT) is the most common treatment method for andropause. TRT involves replacing the declining testosterone levels with synthetic or bioidentical hormones.
There are many different ways of getting your treatment, including:
- Weekly injections (either self-administered or administered at a clinic once or twice a week)
- Pellets (time-released tablets of medication that are implanted under the skin — usually last for 3–6 months)
- Gels or creams (applied daily — require a great deal of care because they can easily transfer to other people and cause significant problems, especially for women and children)
- Patches (replaced once a day)
These medications will have to be prescribed by your provider and filled by a pharmacist — there are no testosterone replacement therapy drugs available over the counter.
You Don’t Have to Suffer Any Longer
Andropause is a natural phase of life that many men will navigate as they age. By understanding the symptoms, causes, and available treatment methods, you can effectively manage andropause and maintain a high quality of life.
It's important to discuss the pros and cons of each form of TRT with your healthcare provider to determine which one is right for you.
To learn more about testosterone replacement therapy and discuss your options, schedule an appointment today.