The Male Menopause

When it comes to menopause, many people will assume that only women will experience it. But over the last few decades, there has been increasing recognition of a so-called “male menopause”.

What Is Male Menopause?

The term “male menopause,” or andropause, as it is sometimes called, is often inaccurately used in the media. It implies that the symptoms stem from a sudden decrease in testosterone during middle age, akin to what women experience during menopause. However, this is inaccurate.

While testosterone levels do decline gradually in men as they age, typically decreasing by about 1% per year starting around the ages of 30 to 40, this decline alone is not usually problematic. Symptoms often attributed to male menopause may actually stem from various factors unrelated to hormonal changes.

Although a testosterone deficiency, known as late-onset hypogonadism, can contribute to these symptoms in some cases, it is important to recognise that hormonal changes are not always the primary cause.

What Is Late-Onset Hypogonadism?

Late-onset hypogonadism, also known as testosterone deficiency syndrome, is a condition where the testes produce insufficient levels of testosterone, leading to symptoms commonly associated with male menopause. While some cases of hypogonadism may be present from birth and manifest with symptoms like delayed puberty and small testes, late-onset hypogonadism typically develops later in life, often in men who are obese or have type 2 diabetes.

Late-onset hypogonadism is characterised by symptoms such as fatigue, reduced libido, erectile dysfunction, mood changes, and decreased muscle mass. Although it is less common than an age-related decline in testosterone levels, it is essential to recognise that it is a distinct medical condition and not simply a normal part of ageing.

Diagnosing late-onset hypogonadism usually involves evaluating symptoms and conducting blood tests to measure testosterone levels. Treatment options may include testosterone replacement therapy or addressing underlying health conditions contributing to hypogonadism, such as obesity or diabetes. Consulting with a healthcare professional is crucial for an accurate diagnosis and appropriate management of symptoms.

What Causes Male Menopause?

You might ask, why are younger men affected by male menopause as well? Here are some probable causes.

• Medical conditions: Certain medical conditions, such as obesity, diabetes, thyroid disorders, and sleep apnea, can contribute to symptoms that are commonly associated with male menopause.
• Medications: Some medications, including certain antidepressants, anti-anxiety drugs, and opioids, can affect hormone levels and contribute to symptoms like fatigue, low libido, and erectile dysfunction.
• Lifestyle factors: Poor diet, lack of exercise, excessive alcohol consumption, smoking, and chronic stress can all contribute to symptoms of male menopause or exacerbate existing symptoms.
• Psychological factors: Anxiety, depression, and other psychological factors can play a role in the development or exacerbation of symptoms associated with male menopause.

What Are the Signs and Symptoms of Male Menopause?

Signs and symptoms of male menopause may include:

• Decreased libido or sexual drive
• Erectile dysfunction
• Increased body fat and muscle mass loss
• Loss of bone density
• Depression
• Irritability
• Anxiety
• Restlessness
• Impaired memory
• Inability to concentrate
• Fatigue
• Lack of stamina and physical strength
• Insomnia and sleepiness
• Loss of appetite

How Is Male Menopause Diagnosed?

The diagnosis of male menopause is not as straightforward as diagnosing a medical condition with specific criteria.

Diagnosing male menopause typically involves a combination of medical history, physical examination, and investigations.

Blood tests may be conducted to measure hormone levels, including testosterone, to assess for any hormonal imbalances. However, it is important to note that there is no specific threshold of testosterone levels that defines male menopause, as testosterone levels can vary widely among individuals and decline gradually with age.

Since symptoms commonly associated with male menopause can be caused by a variety of factors beyond hormonal changes, your doctor may also consider other potential causes, such as medical conditions, medications, lifestyle factors, or psychological factors.

How Is Male Menopause Treated?

Treatment options may vary depending on the underlying causes of symptoms and may include hormone replacement therapy, lifestyle modifications, or other interventions aimed at addressing specific symptoms or contributing factors.

What Are the Benefits and Cautions of Testosterone Replacement Therapy (TRT)?

Testosterone replacement therapy (TRT) is a treatment option for men with low testosterone levels, which may help alleviate symptoms and maintain bone and muscle strength. TRT can be administered in various forms, including pills, gels, patches, injections, or implants.

While TRT may be beneficial for some men, it is essential to consider potential risks associated with treatment. These risks include infertility, enlarged prostate leading to urinary difficulties, blood clots, worsening cardiovascular disease, sleep disturbances, and cholesterol imbalances. Additionally, there is uncertainty regarding the potential impact of TRT on prostate cancer risk and symptoms of benign prostatic hyperplasia, as well as cardiovascular risks.

Discussing TRT’s potential benefits and risks with your doctor is crucial to determine if it is an appropriate treatment option. If you decide to undergo TRT, regular checkups with your doctor are necessary to monitor your response to treatment and manage any potential side effects. If there is no noticeable improvement in symptoms after three months of treatment, the effectiveness of TRT may be limited for you.

Make An Appointment At Pantai Hospitals

For men experiencing symptoms associated with male menopause, taking action to address these concerns is crucial for maintaining overall health and well-being. Get in touch with us to book an appointment with a urologist today if you have any concerns or questions about male menopause.

Pantai Hospital has been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.