Does a male menopause exist?

Most women who have gone through menopause will laugh and say “no way” if you ask them if a man goes through the same thing.   Menopause in women and any kind of a “male menopause” in men are two very different things. 

Female and male menopause compared

For women, menopause occurs when the hormone estrogen produced by the ovaries declines sharply, ending ovulation and the chance to become pregnant.  With the start of menopause, estrogen production dramatically plummets during a relatively short period of time. Most but not all women will have specific symptoms associated with this phase of life. 

For men, their male menopause is due to the natural, more gradual decline in the hormone testosterone.  All men will experience this but by the age of 80, between 40 to 50 percent of men will have a “low” range of testosterone.  This is typical in older men since testosterone levels decline throughout adulthood at about 1 percent a year after the age of 30.  As the testosterone levels decline men may notice body changes of a decrease in muscle mass and an increase in body fat.

Instead of the term male menopause, many doctors use the term “andropause” or “testosterone deficiency syndrome” or even “androgen deficiency of the aging male.”  No matter what it is referred to, the hormonal changes men experience are real and are considered a normal part of aging.

How to recognize male menopause

To definitively diagnose a low testosterone level, blood tests will need to be done including checking on free testosterone which gives more information when total testosterone is low.  Because testosterone levels vary and are generally highest in the morning, blood testing is usually done early in the day around 8 a.m.

It is common for some men with a lower than normal testosterone level to have no signs or symptoms.  If this is the case, then no treatment is necessary.  Some men though, may experience the following:

·         Sexual function changes – Might include erectile dysfunction, fewer spontaneous erections, low libido, infertility and the testes can reduce in size.

·         Sleep pattern disturbances – May include insomnia or increased tiredness.

·         Physical changes – Increased body fat or weight gain, decreased muscle mass and strength, reduced bone density, increase in size of breasts (gynecomastia), and loss of body hair.

·         Emotional changes – Reduced motivation or self-confidence.  Feelings of sadness, depression, trouble concentrating or remembering things.

Underlying factors can sometimes be the cause of symptoms other than low testosterone.  Such factors could include medication side effects, thyroid problems, depression and excessive alcohol use.  If an underlying factor is discovered for the cause of symptoms, it should be treated as soon as possible.

Treating male menopause

Whenever a man is experiencing any of the symptoms of low testosterone or just not quite like himself, he should discuss this with his doctor.  They can evaluate the reasons for these changes and prescribe a treatment option.  Here are some options they may recommend:

·         They should first rule out any possible underlying factor causing symptoms of low testosterone.

·         Eating a healthy diet along with including physical exercise should be part of a daily routine.  Adopting a healthy lifestyle helps maintain strength, energy and lean muscle mass.  It can also have a positive impact on achieving better sleep.

·         Men who are depressed may need to seek counseling or possibly anti-depressant medication. 

·         Avoid herbal supplements touting to treat low testosterone.  They haven’t been tested or approved by the Food and Drug Administration (FDA) and some could be dangerous.

 Testosterone replacement therapy (TRT) is another option but is controversial.  It can be tempting for a doctor to want to treat all men with low testosterone with TRT but it is advised not to do this. Some men will experience reduction in the signs and symptoms of testosterone deficiency when placed on TRT.  Other men may not.  The advantages of it include decreasing the risk of heart disease and osteoporosis.  The disadvantages can be an increased risk in blood clotting, acne, and breast enlargement. 

 Some men have concerns of taking testosterone replacement therapy with an increased risk of prostate cancer.  There have been shown no cause and effect when it comes to testosterone and prostate cancer but there is an association especially if you’re in a high-risk category – African-American or have a family history. The doctor should check a man’s prostate specific antigen levels (PSA) before going on testosterone therapy with continued frequent monitoring of the PSA thereafter.

 Ultimately, a man and his doctor will need to decide the best ways to treat any symptoms associated with male menopause.  Just like every woman is different, every man is different too and what works for one man may not work or be beneficial to another.