Male Menopause: Fact or Fiction?
Melissa Conrad Stöppler, MD
C. Shiel Jr., MD, FACP, FACR
An upsurge in media attention recently regarding the so-called "male
menopause" has left many men rushing to their doctor to treat symptoms they
believe may be related to low levels of testosterone. Also referred to as low-T, andropause, or (its medical name) late-onset hypogonadism, the idea behind the
concept of male menopause is that the decline in testosterone levels that occurs
as men age may be producing a characteristic and potentially treatable set of
But some experts argue that the analogy to the process in women (with some
authors even using terminology like "male PMS") has been carried too far. While
it is true that testosterone levels do decline as a man ages, the decline in
female hormones occurs to a significantly greater extent, and the symptoms in
women associated with decreased estrogen levels are known and have been
clinically documented for years.
Symptoms of a potential male menopause are less clearly defined.
dysfunction is a common complaint, but other nonspecific symptoms- like
depression, mood changes, weight gain, or fatigue- have been interpreted by some
as symptoms of a male midlife change....
Male Menopause Introduction
Women may not be the only ones who suffer the effects of changing hormones. Some doctors are noticing that their male patients are reporting some of the same symptoms that women experience in perimenopause and menopause.
The medical community is currently debating whether or not men really do go through a well-defined menopause. Doctors say that male patients receiving hormone therapy with testosterone have reported relief of some of the symptoms associated with so-called male menopause.
What Is Male Menopause?
Because men do not go through a well-defined period referred to as menopause, some doctors refer to this problem as androgen (testosterone) decline in the aging male, or what some people call low testosterone. Men do experience a decline in the production of the male hormone testosterone with aging, but this also occurs with conditions such as diabetes. Along with the decline in testosterone, some men experience symptoms that include fatigue, weakness, depression, and sexual problems. The relationship of these symptoms to decreased testosterone levels is still controversial.
Unlike menopause in women, when hormone production stops completely, testosterone decline in men is a slower process. The testes, unlike the ovaries, do not run out of the substance it needs to make testosterone. A healthy male may be able to make sperm well into his eighties or longer.
However, as a result of disease, subtle changes in the function of the testes may occur as early as 45 to 50 years of age, and more dramatically after the age of 70 in some men.
How Is Male Menopause Diagnosed?
To make the diagnosis of male menopause, the doctor will perform a physical exam and ask about symptoms. He or she may order other diagnostic tests to rule out any medical problems that may be contributing to the condition. The doctor will then order a series of blood tests, which may include measuring testosterone level.
Can Male Menopause Be Treated?
If testosterone levels are low, testosterone replacement therapy may help relieve such symptoms as loss of interest in sex (decreased libido), depression, and fatigue. But, as with hormone replacement therapy in women, testosterone replacement therapy has potential risks and side effects. Replacing testosterone may worsen prostate cancer, for example.
If you or a loved one is considering androgen replacement therapy, talk to a doctor to learn more. Your doctor may also recommend certain lifestyle changes, such as a new diet or exercise program, or other medications, such as an antidepressant, to help with some of the symptoms of male menopause.
WebMD Medical Reference
MSNBC: "Male Menopause Out of the Closet."
WebMD Feature: "Menopause: Not Just For Women."
Mayo Foundation for Medical Education and Research: "Male menopause: Myth or reality?"
womenshealth.gov: "Aging Male Syndrome."
Mayo Foundation for Medical Education and Research: "Testosterone therapy: Can it help older men feel young again."
MedlinePlus Medical Encyclopedia: "Aging changes in the male reproductive system."
Reviewed by Melinda Ratini, DO, MS on June 29, 2012