Between the ages of 40 and 55, men can experience a phenomenon which is similar to the female menopause that is referred to as male andropause.

When a woman reaches her late forties or early fifties, she undergoes bodily changes associated with reduction of female sex hormones and the ending of her periods. These changes are often associated with symptoms such as hot flashes, mood swings and/or depression, vaginal dryness, atrophic changes in the vagina and skin, reduced sexual desire, and an accelerated bone loss leading to osteoporosis. These changes in a woman are called the female menopause. The symptoms and signs associated with this condition can generally be corrected with the judicious use of natural hormonal replacement therapy. Unfortunately, most gynecologists today do not use natural female hormones for replacement, but rather synthetic hormones or hormones that do not entirely match the female hormones that are being replaced.

The concept of a male andropause has been more controversial than that of the female menopause, with many arguing that it doesn’t exist. Part of the reason for the controversy is that, in contrast to women, men do not have a clear-cut external signpost, namely the cessation of menstruation. Nevertheless, even though women do have this clear-cut demarcation, the changes that take place in their bodies associated with the stopping of menstruation, occur gradually over months or even years. This period, during which a woman may experience irregular menstrual periods, hot flashes, mood swings and other bodily changes, is often called the peri-menopausal period.

A man often begins to experience changes in his body somewhere between ages 40 and 55. These bodily changes may be accompanied by changes in attitudes and moods. During this time a man frequently begins to question his values, accomplishments and the direction of his life. The entire gestalt of these changes has led to the notion of the mid-life crisis. In this series, I’ll not focus on all aspects of these changes, but rather on the physical bodily changes that has been termed the male menopause or andropause. We’ll look at what occurs and what can be done to slow down these inevitable changes of aging.

1. Low sex drive
   • Decreased libido
   • Erectile dysfunction

2. Lack of energy
   • Depressed mood
   • Decreased cognitive function (lack of focus)
   • Decreased general wellbeing
   • Loss of muscle mass and strength

3. A growing waist
   • Abdominal obesity

Diagnosing Andropause

A reason why Andropause has been under-diagnosed over the years is that symptoms can be vague and can vary a lot among individuals. Some men find it difficult to admit that there's even a problem. And often physicians didn't always think of low testosterone levels as a possible culprit. So these factors often lead doctors to conclude that symptoms were related to other medical conditions (i.e. depression) or were simply related to aging and often encouraged their patients to accept that "they were no longer spring chickens". But this situation is changing.

New blood testing methods are available and there is a increased interest in men's' aging among medical researchers. In fact, so much attention is being focused on Andropause that major efforts are underway to quickly share emerging scientific information with Canadian physicians.

Andropause…New Phenomenon?

Yes and no. Obviously, not for nature. As a clinical phenomenon, andropause was first described in medical literature in the 1940's. In spite of that description, until now, the ability to effectively diagnose this syndrome has been limited.

 Andropause has gone through a long period where it was under-diagnosed and under-treated. In fact, it even went unacknowledged! Fortunately, doctors now have a new sensitive “bioavailable testosterone” test for measuring testosterone. This test measures active testosterone which is the testosterone that is actually doing something. With this technology, andropause has now been identified as a legitimate clinical concern!

Since men are living longer, there is heightened interest in the andropause.

Men… Hormones Decline Gradually

Unlike menopause, which generally occurs in women during their mid-forties to mid-fifties, men's "transition" is much more gradual and it happens over many decades. Attitude, psychological stress, alcohol, injuries, surgery, medications, obesity and infections can contribute to its onset.

With age, a decline in testosterone levels will occur in virtually all men, although there is no way of predicting who will experience andropause symptoms severe enough to seek medical help, nor is it predictable at what age symptoms will occur in a particular individual. Where andropause is concerned, each man's symptoms may be different.