Andropause: Understanding male menopause

Written in association with: Dr Shemitha Rafique
Published: | Updated: 20/06/2024
Edited by: Kate Forristal

Andropause, often referred to as male menopause, is a condition associated with a decline in testosterone levels in aging men. Unlike menopause in women, which occurs relatively quickly when the ovaries stop producing hormones, andropause is a more gradual process that can extend over many years. In her latest online article, Dr Shemitha Rafique gives us her insights. 

What is andropause?

Andropause is characterised by a decline in testosterone, the primary male sex hormone, and can lead to a variety of symptoms. It typically affects men between the ages of 40 and 60, although it can start earlier or later. The term "andropause" is somewhat controversial as it implies a direct correlation with menopause, which is not entirely accurate given the differing mechanisms and symptoms.

 

Causes of andropause

The primary cause of andropause is the natural decline in testosterone production with age. Several factors contribute to this decline:

  1. Aging: Testosterone levels naturally decrease by about 1-2% per year after the age of 30.
  2. Health conditions: Conditions like obesity, diabetes, and chronic illnesses can exacerbate the decline.
  3. Lifestyle factors: Poor diet, lack of exercise, excessive alcohol consumption, and smoking can contribute to lower testosterone levels.
  4. Medications: Certain medications, especially those used to treat chronic diseases, can affect hormone levels.

 

Symptoms of andropause

The symptoms of andropause can vary widely among individuals and may include:

 

Physical symptoms:

  • Decreased muscle mass and strength Increased body fat
  • Reduced bone density
  • Fatigue and decreased energy levels
  • Hot flashes and sweating

 

Sexual symptoms:

  1. Reduced libido
  2. Erectile dysfunction
  3. Decreased sexual satisfaction

 

Emotional and psychological symptoms:

  • Mood swings
  • Depression
  • Irritability
  • Difficulty concentrating and memory problems

 

Diagnosing andropause

Diagnosing andropause involves a combination of symptom assessment and laboratory tests. Doctors typically look for the following: 

  1. Symptom assessment: A comprehensive evaluation of the patient's symptoms and medical history.
  2. Blood tests: Measuring testosterone levels through blood tests. These tests are often conducted in the morning when testosterone levels are at their peak.
  3. Additional tests: Other hormone levels, such as luteinising hormone (LH) and follicle-stimulating hormone (FSH), may also be measured to rule out other conditions.

 

Treatment options

Treatment for andropause aims to alleviate symptoms and improve quality of life. Options include:

Lifestyle changes:

  • Regular exercise
  • Healthy diet
  • Adequate sleep
  • Stress management

 

Hormone replacement therapy (HRT):

  • Testosterone replacement therapy can be administered through injections, patches, gels, or tablets.
  • Regular monitoring is necessary to adjust dosage and check for side effects.

 

Medications:

  • Medications to treat specific symptoms such as erectile dysfunction (e.g., sildenafil).

 

Psychological support:

  • Counselling or therapy to address mood swings, depression, and other psychological symptoms.

 

Risks and considerations

While testosterone replacement therapy can be effective, it is not without risks. Potential side effects include:

 

It is crucial for patients to discuss the benefits and risks with their healthcare provider to make an informed decision.

 

You can schedule an appointment with Dr Rafique on her Top Doctors profile.

By Dr Shemitha Rafique
Endocrinology, diabetes & metabolism

Dr Shemitha Rafique is an experienced consultant in diabetes, endocrinology and general medicine at Chelsfield Park Hospital. She graduated in 2000 and completed her M.D. in Medicine in 2004. She further specialised in diabetes and endocrinology in the UK, training at various NHS hospitals, including Guys St. Thomas' NHS Trust.
 
Dr Rafique is a full-time consultant at Princess Royal University Hospital, Kings College NHS Foundation Trust, where she runs weekly endocrine, diabetes, and bariatric clinics. Dr Rafique has conducted research during her M.D. She trains doctors, publishes cases in endocrine journals and presents at professional meetings. She continuously updates her knowledge to benefit her patients and regularly teaches students and trainees.
 
As the lead for governance at her hospital, Dr Rafique prioritises patient safety. She is committed to early diagnosis and appropriate treatment, looking at patients holistically. Her interests include thyroid diseasesadrenal and reproductive endocrinologydiabetes management, and obesity management. Dr Rafique is dedicated to helping her patients optimise their health and prevent complications.

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