By Mike Kocsis | 7 minutes read | Last updated: August 15, 2022 Categories: Andropause Men's Health
Medically Reviewed by Dr. George Touliatos
Both men and women experience hormonal changes as they age. Women see a sudden drop in their sex hormone level, while men experience a gradual decline.
Some doctors are seeing older men experience the same symptoms as women going through perimenopause and menopause and are beginning to question whether men also experience menopause due to declining testosterone with age.
This article explains the term ‘male menopause’ and discusses its causes, symptoms, and treatment options.
What is male menopause?
Male menopause is a term used to describe hormonal changes that occur in men as they age. Some experts also call it late-onset hypogonadism or androgen (testosterone) deficiency.
Unlike women, age-related hormonal changes in men do not occur during a short time period. Testosterone decreases gradually over a period of several years.
It is normal for men to have low testosterone levels in their bloodstream after the age of 50. However, it can also occur due to certain health conditions, including diabetes, obesity, etc.
Testosterone is a male sex hormone that regulates many important processes such as fertility, bone density, and muscle mass. Fluctuation can cause menopausal symptoms, but in many cases, menopausal symptoms are not directly related to testosterone levels – they can be associated with a certain medication or health problems.
How is male menopause different from female menopause?
Male menopause is often misunderstood and related to female menopause, in which a sudden drop in estrogen (a female sex hormone) levels occurs. For men, the decline is more steady and over a longer period of time decline at a rate of 1 per cent every year after 30 years of age.
- The majority of older men have healthy testosterone levels. Only 10 per cent to 25 per cent have low testosterone.
- Every woman goes through menopause , while not all men have menopause.
- Symptoms of female menopause start appearing soon after the drop in progesterone and estrogen levels. They emerge fast and are severe, while male menopause symptoms take time to appear and are less severe.
- This condition is called male menopause because its symptoms are similar to those of female menopause.
What are the symptoms of male menopause?
Male menopause produces mental, physical and sexual symptoms. Some examples of these symptoms are:
- Low energy levels
- Change in mood
- Depression
- Reduced motivation and self-esteem
- Inability to perform strenuous tasks properly
- Muscle and bone weakness
- Trouble getting an erection
- Low sex drive
- Breast enlargement
- Low sperm count
A study published in The New England Journal of Medicine concludes that sexual symptoms including erectile dysfunction, low libido, and poor morning erection are the most common symptoms of male menopause.
Rare symptoms of male menopause
Some men experience uncommon symptoms. Some of these are:
- Hot flushes
- Swollen breasts
- Loss of body hair
What causes male menopause?
While male menopause is linked with age-related testosterone decrease, many doctors believe it is not the only cause of this condition. For f it were true, every man would experience it.
Male menopause can express itself differently in different men, the symptoms of two menopausal men are not always similar. While these symptoms appear in aged men having low testosterone, they also appear in aged men having type 2 diabetes, high blood pressure, obesity, and other similar conditions.
Risk factors that may contribute to it are:
- Lack of physical activity
- Lack of sleep
- Stress
- Anxiety or depression
- Excessive consumption of alcohol
- Low self-confidence
- Poor diet
How is it diagnosed?
In order to start treatment for male menopause, your doctor will first have to diagnose the issue causing it. As we have previously mentioned, many factors can contribute to this issue. That is why identifying the real issue is important.
A doctor may use the following ways to diagnose the cause.
Ask about your symptoms
Many men often get shy while talking about their menopause symptoms (particularly when talking about their sex life) and hesitate to tell everything they are experiencing to their doctors. But staying quiet will not help, it may even complicate things for your doctor.
A symptom is evidence of a health issue. It would help if you described them clearly and in as much detail to point your doctor in the right direction so you can receive the correct diagnosis.
Physical examination
A physical examination is performed to identify possible medical signs. Your doctor may look at:
- Your body mass and bone strength
- Your testes and breast size
- The amount of body hair
- Lumps in testes and scrotum
Blood tests
This test is performed to check your blood testosterone levels. Your blood sample will be taken from your blood vessel located in your arm and sent to the lab for analysis.
Testosterone levels fluctuate throughout the day. Generally, they are high in the morning, so your blood sample will be taken in the morning. If the report of your first test shows you have low testosterone levels, the doctor will ask you to have another blood test to ensure you really have low T.
In adult men, 300 to 1,000 nanograms per deciliter (ng/dL) testosterone level is considered normal. An amount lower than this is regarded as abnormal, and it shows you have testosterone deficiency.
Rule out medical conditions
Your doctor may also ask you to have some other tests like a CT scan, genetic studies, or hormone test to rule out certain medical conditions.
A CT scan is done when your doctor thinks your low T is due to a pituitary tumour. Similarly, a genetic test is done when your doctor thinks a genetic issue is causing the abnormality. It shows your genetic makeup to your doctor and helps them identify any abnormalities in your genes.
Pituitary hormones control the production of testosterone by testes. If your pituitary gland isn’t working properly, your testes will not get a proper message and produce low testosterone. Therefore, hormone tests are performed to check the levels of pituitary hormones.
Once the cause has been diagnosed, your doctor will design a suitable treatment plan.
Is there any treatment for male menopause?
Your doctor will recommend some lifestyle changes if your menopause symptoms are not severe.
Depending on your individual circumstances, you may receive a dietry plan or medication to make sure you’re in peak physical condition. This is to help you manage your symptoms and tackle the issue causing menopause.
If your testosterone levels are too low or lifestyle changes are not producing noticeable results, your doctor may suggest testosterone replacement therapy (TRT). It requires you to take the prescribed testosterone dose regularly as per your doctor’s advice. Its goal is to restore your blood testosterone levels and reduce low T symptoms.
Am I the right candidate for TRT?
TRT is an effective treatment that has helped millions of men to reduce their menopause symptoms. But, it does come with some side effects and risks. Patients who are on TRT may report the following issues.
- Acne
- Low sperm count
- Increase in breast size
- Risk of blood clot formation
- Risk of prostate abnormalities
You need to discuss side effects with your doctor to determine if the treatment is safe for you. People with certain medical conditions such as prostate cancer, urinary tract infection, and breast cancer are usually advised to not have this treatment. Men who plan to have children should also avoid this therapy as it can decrease sperm production.
Things you need to know before starting TRT
If you are planning to start TRT, here are some important points you need to know before getting started.
- TRT is given in different forms. Each form has its pros and cons. Discuss them in detail with your doctor to select the best possible TRT form.
- Once you start the treatment, you will have regular follow-up sessions. During these sessions, your doctor will check your testosterone levels, body fat, bone density, and prostate cancer risk.
- Some TRT side effects can be life-threatening for some people. You should tell your doctor your medical history and discuss risks before selecting this treatment option.
- TRT is a life-long therapy. Your testosterone levels will decline and come back to what they used to be before starting TRT if you stop taking testosterone.
Conclusion
Male menopause is a condition that is difficult to diagnose because its symptoms vary from man to man and there can be a number of causes.
One of the causes of menopause is low testosterone. If you are diagnosed with it, you should talk to your doctor about TRT, which can bring your low testosterone levels back to normal.
References/Bibliography/ Further Reading/Citations/Scientific Studies
Pines, A., 2011. Male menopause: is it a real clinical syndrome?. Climacteric, 14(1), pp.15-17.
Huo, S., Scialli, A.R., McGarvey, S., Hill, E., Tügertimur, B., Hogenmiller, A., Hirsch, A.I. and Fugh-Berman, A., 2016. Treatment of men for “low testosterone”: a systematic review. PloS one, 11(9), p.e0162480.
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About the Author: Mike Kocsis
Mike Kocsis has an MBA with a focus on healthcare administration and is an entrepreneur and medical case manager for Balance My Hormones which offers medical services in the UK and Europe. Mike has over 20 years of experience in the healthcare sector, much of that working with people who have hormone imbalances. Mike has appeared on podcasts and radio and is an expert speaker on the subject of hormone imbalance. He specialises in Testosterone Replacement Therapy and Hormone Replacement Therapy (HRT) and has helped thousands of people suffering from hormone imbalances recover and regain control of their lives. You can follow him on LinkedIn and on the Balance My Hormones YouTube Channel.
Last update: August 15th, 2022
