Andropause – the hormone is not your servant

Menopause in men

Perhaps some of you have thought deep down: "Finally! Finally, these disgusting men will get it too." And to be honest, we do get something. Andropause occurs in about half of men after the age of 50. Considering this relatively high percentage of such serious changes in the functioning of the male body, there is still very little talk about it, and the term "male menopause" is at best covered in silence. This is probably because the word "andropause" itself is a kind of mental shortcut or a significant linguistic simplification. It brings to mind its not entirely faithful female equivalent, menopause . And although the scientific community has been proposing other names for years, such as: male menopause, andropenia or PADAM ( partial androgen deficiency in aging male ), andropause has gained "recognition" in the already small human collective consciousness.

Andropause – what is it anyway?

So let's start from the beginning. Andropause is a period in which the male body experiences a decrease in the level of sex hormones, especially testosterone, as well as a few others, including growth hormone and melatonin. These changes entail a number of health consequences - in addition to the typical physical changes that appear in the process of natural aging, problems also occur on several other levels: somatic, psychological and sexual.

Causes of andropause

Andropause occurs, similarly to menopause, as a result of those hormonal changes that everyone hates. However, man does not live by hormones alone, which means that although we do not always have an influence on the level of testosterone in the body, there are a whole host of activities and behaviors that changes caused by a deficiency of this hormone can only deepen and accelerate:

• poor diet,
• sedentary lifestyle,
• smoking,
• drinking excessive amounts of alcohol,
• obesity.

Although andropause in men usually occurs after the age of 50, there have been reports of symptoms of andropause appearing in people as young as 40. An earlier onset of menopause may be the result of lifestyle diseases, which, in addition to the above, also include diabetes and atherosclerosis. It is therefore impossible not to constantly remind ourselves of the importance of taking care of our health and physical condition (but also mental condition, which is always worth starting first) in order to avoid andropause altogether or at least its earlier onset.

Symptoms of andropause

As I mentioned above, there are many symptoms of male menopause that affect many aspects of a man's life.

Physical and physical changes

Remember that many physical symptoms of andropause can be easily overlooked, simply taken for the effects of the body's natural aging process. Perhaps that is why the problem of andropause in men is so often ignored - it goes unnoticed. So how can you recognize it? The first symptoms of andropause (at least the physical ones) do not allow for an accurate diagnosis. These include:

• loss of energy,
• appetite disorders,
• sleep disturbances (including afternoon sleepiness),
• increase in the share of fat tissue in total body weight,
• loss of muscle mass,
• reduction of hair all over the body.

The picture that emerges from the above symptoms is most often simply related to the fact that the man has already passed his first youth. Therefore, it is important not to end your observations only at the physical level.

Psychological changes

Just like in women during menopause, in men andropause also manifests itself with psychological problems. Symptoms that should draw our attention are:

• trouble concentrating,
• memory problems,
• irritability,
• feeling of fear and uncertainty,
• lower mood and decreased life satisfaction.

These ailments may vary in intensity in relation to each individual case, but they undoubtedly constitute a vicious circle in which men fall, only deepening their aversion, aggression and various types of tensions in relation to both their lives and the people around them. This is because at a certain age, a man looks at his life holistically, makes an "examination of conscience", which may lead to a feeling of lack of fulfillment in life.

Sexual changes

This type of change, as research on the subject shows, is the most painful for men. The fact that the male body experiences a decrease in the level of hormones regulating sexual drive has the following consequences:

• decreased libido,
• difficulty achieving a full erection,
• decreased satisfaction with sexual life.

You can read more about libido and erection in our article: The structure of the penis – a lesson in practical anatomy .

Other symptoms of andropause

In men during andropause, as in women during perimenopause, hot flashes, excessive sweating, or heart rhythm disturbances may occur. Decreasing testosterone levels can also affect the enlargement of the prostate gland , which causes problems with urination.

Andropause vs. Fertility

One of the sources of the rather strong opposition from the medical community to the very name of this group of ailments lies precisely in the sphere of fertility. Therefore, one should not equate menopause with andropause, because men retain their reproductive functions even during this period. Due to the lowered level of testosterone, sperm production is significantly reduced, but this does not affect the sexual abilities of those affected by andropause. However, there remains the issue of impotence, which - although it can have a physical basis in the form of a decrease in libido - has its source more in the psyche.

Treatment of andropause

As with menopause, andropause should be treated as a natural process that cannot be avoided in any way. The treatment plan is therefore based on relieving symptoms and replenishing deficiencies. Depending on the patient's needs, the doctor will apply the appropriate therapy. It may consist of:

• Hormone replacement therapy – which involves supplying the body with declining testosterone. The treatment must be carried out under strict medical supervision, as side effects can occur. The use of testosterone has a contraceptive effect. Men trying to have children can use, for example, recombinant luteinizing hormone, which is a preparation that stimulates the testicles to produce testosterone. People undergoing this type of therapy regain a certain percentage of dry body mass, note a decrease in fat tissue, and their sexual performance improves.
• Symptomatic treatment – ​​Given that andropause affects so many areas of male health, it is also possible to alleviate individual symptoms. Always seek advice from a doctor who will be able to assess the scale of the problem and prescribe appropriate measures, such as potency, sleep or mood-enhancing drugs.
• The use of DHEA (dehydroepiandrosterone) in the treatment of reduced sexual performance – according to research, supplementation of this hormone improves the quality of sexual life (regardless of gender).
• Lifestyle change – increasing physical activity, changing diet, giving up stimulants.

Let's talk about andropause!

Although there is still a long way to go in terms of educating the public about menopause, at least the discussion is happening and the information is readily available. The situation is slightly different when it comes to andropause. I even came across a scientific paper that stated that it is a “controversial topic,” which only goes to show the scale of the problem of lack of access to reliable information for 50%(!) of ageing men.

I would like to avoid pigeonholing menopause into the category of “who has it worse,” but it seems that there is still a lot to be done when it comes to combating the stereotypical perception of men as strong Macho Man, who, even after fifty, will flex his muscles and do triple backflips just to hide his weaknesses – and let’s be honest, every person experiences them. So let’s talk, share knowledge and take care of each other. :)

S. Hakimi, L. Ghasemi, M. Mirghafourvand et al., The Prevalence of Andropause Symptoms and the Role of Social Determinants of Health on its Severity in Healthy Men: A Community-based Study in Northwest Iran , "Crescent Journal of Medical and Biological Sciences" 2019, vol. 6, i. 3, p. 341-345.
G. Jarząbek-Bielecka, K. Plagens Rotman, W. Kędzia et al., The importance of DHEA in sexual health during menopause , "Farmacja Polska" 2020, no. 76, no. 9, pp. 537-540.
K. Walaszek, B. Tomala, I. Kowalska et al., Andropause and the aging process and the quality of life of men over 50 , "Forum Medycyny Rodzinnej" 2017, no. 11, no. 5, pp. 209-215.