In the medical realm, not everyone agrees that the term “male menopause” is appropriate or accurate. After all, the word “menopause” (and perimenopause) when applied to women suggests a significant and somewhat sudden drop in sex hormone levels. This is not the scenario in men, in whom the decline is mostly slow and gradual. However, although the terminology may be off target, the real question is, is male menopause real?
What is male menopause?
The phenomenon of male menopause (aka, andropause) occurs primarily in men aged 50 and older when their production and plasma concentrations of testosterone decline. Although T typically begins a downward journey around age 30, many men don’t usually notice symptoms for several decades.
Symptoms of male menopause (at one time called male climacteric, which suggests a gradual decline rather than a sudden drop in T levels and concentrations) include fatigue, poor memory, depression, mood swings, lack of sex drive, erectile dysfunction, nervousness, accumulation of belly fat, sweats and flush. Because many of the symptoms men experience associated with hormone decline are similar to those that affect women, the term “male menopause” was coined decades ago and is still used today.
Why male menopause symptoms occur
As men age, they experience a decline in leydig cells in the testicles or problems with their hypothalamic-pituitary balance (or both). This results in abnormally low release of luteinizing hormone and low T production.
As testosterone levels decline, so do levels of sex hormone-binding globulin (SHBG), which in turn contributes to an even greater drop in bioavailable testosterone. Low testosterone levels can then translate into one or more of the symptoms already named.
Although any of the symptoms linked with male menopause can be disturbing for men, those affecting sexual function can be the most worrisome. Optimal testosterone levels for sexual functioning is around 10.4 mmol/L (300 ng/dL), although these numbers are not set in stone and can vary considerably depending on the man. For some males, changes in the concentrations of dihydrotestosterone, a metabolite of T, have an impact on sexual function.
Dealing with male menopause
Similar to women, who may turn to estrogen replacement therapy to combat menopausal symptoms, men who are experiencing symptoms of male menopause or andropause sometimes heed the call of the advertisements for testosterone replacement therapy. Like estrogen replacement, there is also controversy surrounding the use of testosterone replacement therapy (TRT) for men who are experiencing symptoms of low T.
Since TRT is associated with side effects such as increased risk of heart attack or stroke, acne and oily skin, decline in sperm count, higher risk of blood clots, breast enlargement, and shrinking testicles, men are encouraged to use natural means to boost their testosterone levels. Some of those techniques include:
- Get sufficient sleep: your body produces testosterone while you sleep, so get at least 7 hours every night
- Practice stress reduction: the release of the stress hormones cortisol and adrenaline can disrupt your testosterone levels
- Drop excess body fat: fat cells transform testosterone into estrogen, so if you lose that fat, you can help stop the loss of testosterone
- Limit alcohol: use of alcohol reduces testosterone production
- Indulge in certain foods: foods such as Brazil nuts (high magnesium), oats (have avenacosides, which boost release of luteinizing hormone, which stimulates T), cruciferous veggies (help eliminate estrogen), and fish oil (boosts production of luteinizing hormone), among others.
- Avoid toxins: environmental toxins, including food additives, air pollutants, phthalates, bisphenol-A, and many more can have a negative impact on hormone levels
- Explore natural testosterone supplements: with many on the market, it is important to do your research on the ingredients included. Are they clinically supported?
Men typically experience a decline in testosterone levels, although the drop is not nearly as dramatic as the one women go through with menopause. Although the nomenclature may be inaccurate, many men do develop symptoms associated with lowered testosterone levels, many of which resemble those women experience during menopause. Is male menopause real? You decide.
Gould DC, Petty R. The male menopause: Does it exist? Western Journal of Medicine 2000 Aug; 173(2): 76-78
Heller CG, Myers GB. The male climacteric, its symptomatology, diagnosis and treatment. JAMA 1944; 126:472-77