Andropause is the term commonly used to describe the point at which a man’s androgen hormone levels have reached substantial decline, initiating a host of uncomfortable symptoms, such as fatigue, night sweats, weight gain, hair loss, or depression. Andropause is known by many names: the male menopause, low T, or “man-o-pause,” but regardless of what it is called, it is a very real condition that affects more than 4 million men in the United States.
Testosterone plays a role in assisting the male body in building protein and is essential to stamina, sex drive, and the ability to achieve an erection. Testosterone also contributes to several metabolic functions including prostate gland growth, liver function, bone formation, and production of blood cells in bone marrow.
The decline of testosterone can begin as early a man’s mid to late twenties and continue with each passing year. Every man experiences decline at different rates. The signs and symptoms of andropause in men are linked to a significant decrease in testosterone, which induces elevated activity of progesterone and estrogen. Sex-binding hormone globulin (SHBG) levels, an androgen-binding protein, also increase during this time. SHGB hinders remaining levels of bioavailable testosterone, or “free T,” as it is sometimes called, impairing its effectiveness. Bioavailable testosterone levels are, according to the American Association of Clinical Endocrinologists, the determining factor for a diagnosis of andropause.
Andropause is similar to the experience women endure during menopause, although it is classically dismissed as mere aging because the hormonal imbalance is a much more gradual decline and there is no defining marker, like the cessation of the menses with menopause. Men often unknowingly describe symptoms of andropause as, “I no longer feel like myself,” or, “I’m 45, but I feel like I’m 70.” Many men do not realize that sleepless nights, constant irritability, and low energy are all a result of hormone imbalance and treatable with hormone therapy. Use this guide to identify your symptoms, then talk to an expert physician in hormone therapy to develop a treatment plan to restore your health, quality of life and a return to feeling more like yourself.
Signs and Symptoms of Andropause in Men
- Hair Loss. Diminishing levels of testosterone can affect the hair follicles ability to regenerate. Dihydrotestosterone (DHT)—a derivative of testosterone—is often to blame. Levels of DHT rise as testosterone levels fall, leading to follicle regression, and ultimately to hair loss associated with aging.
- Weight Gain and Muscle Loss. Low levels of testosterone can cause a decrease in muscle mass, leading to weight gain. This also often occurs in conjunction with a rise in the hormone, cortisol, which increases fat storage and appetite and leads to low energy levels. Cortisol also reduces testosterone activity. Inactive men, on average, will lose approximately 0.5 percent of their muscle mass and strength each year between the ages of 25 and 60. Beyond age 60, men will typically lose one percent each year. At age 70, the annual rate of muscle mass loss increases to two percent. Without adequate testosterone levels, rebuilding and repairing muscle mass is nearly impossible, even with a dedicated physical exercise regimen.
- Low Sex Drive. Testosterone is also known as the hormone of desire. It is the fuel behind the sex drive for both men and women. Decreases in levels of testosterone, along with a rise in estrogenic activity can substantially lower multiple facets of a man’s sexual health, including desire, stamina, erectile function, fatigue, and depression.
- Fatigue. Fatigue is a leading symptom among men experiencing andropause. However, most men dismiss this symptom as part of the aging process. Feeling tired all the time is not normal. Chronic fatigue is a medical issue that should be addressed by a doctor if the condition begins to interfere with daily activities. During andropause, declining testosterone levels can impair a man’s energy reserves to the point of exhaustion, leading to insomnia, sluggishness, and irritability.
- Gynecomastia. Gynecomastia, known in laymen’s terms as “man boobs,” refers to the atypical breast enlargement observed in some men with aging. The condition is often the result of elevated estrogen levels. Obese men are at a greater risk of experiencing gynecomastia because excess body fat increases estrogen levels, regardless of age or testosterone levels, further disrupting hormone balance.
- Hot Flashes and Night Sweats. Night sweats and hot flashes are not limited to the effects of menopause—men can experience the same discomforts. Low testosterone impacts the hypothalamus, which is responsible for regulation of body temperature. Hot flashes and night sweats occur when a hormone imbalance leads neurotransmitters to inappropriately signal the hypothalamus that the body is overheating. This causes the body to naturally react with a warm, flushed sensation and sweating.
- Depression, Moodiness, and Irritability. According to recent studies, men who are testosterone deficient are four times more likely to experience depression than men with balanced hormone levels. Mood disorders are linked to decreases in testosterone and increases in estrogen and cortisol, along with fluctuations in other less-prominent hormones that significantly impact mood and sense of well-being in men.
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