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Andropause or “male menopause” is a recognized medical condition brought about by declining testosterone of male hormone levels with age. By age 70, testosterone levels are about 10 percent of what they were at age 25. It is estimated that 30 percent of men in their 50s will have testosterone levels low enough to be causing symptoms or putting them at risk.
Although andropause, or the decline of testosterone levels, is a normal part of aging, it may be accompanied by a gradual decline in sexuality, mood, and overall energy and can cause serious health risks. By the time men are between the ages of 40 and 55 they can experience andropause.
Men experience gradual physical changes such as loss of muscle mass and increased fat mass. These may be accompanied by fatigue, changes in attitude and mood, and loss of energy, sex drive, and physical agility. Often sleep and concentration are adversely affected as well.
This decline in testosterone can also put men at risk for other health problems like cardiovascular disease and osteoporosis. This timing of andropause may coincide with a mid-life crisis and make matters worse psychologically. Unlike menopause, which generally affects women in their mid-forties to mid-fifties, testosterone decline in men may be much more gradual.
Many factors contribute to the development of andropause including mental attitude, degree of psychological stress, alcohol use, trauma or surgery, prescription and over-the-counter medications, obesity, and infections. While testosterone levels will decline in virtually all men over time, there is no way to predict which men will experience andropausal symptoms or at what age symptoms those symptoms will begin.
Andropause has been underdiagnosed until recently. First described in medical literature in the 1940’s, andropause but was not commonly diagnosed until more sensitive tests for testosterone were available. With increasing life spans in general there is more interest in andropause and in improving quality of life.
Another reason why andropause has been underdiagnosed over the years is that the symptoms can be vague. Some men find it difficult to admit that they have a problem. In addition, physicians may not think of low testosterone levels as a cause of men’s symptoms and consequently many patients are often told they were depressed or just getting older. Andropausal symptoms can significantly impact a man’s quality of life and may lead to long-term risks as well.
New blood testing methods are available and there is 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 physicians worldwide.
Testosterone is an important hormone that has powerful effects on a man’s body. Produced in the testes and in the adrenal glands, testosterone helps build protein and is essential for normal sexual activity. In addition, testosterone affects many metabolic activities such as production of blood cells, bone formation, lipid metabolism, carbohydrate metabolism, liver function and prostate gland growth.
There is great variability in testosterone levels among healthy men so not all will experience the same changes to the same extent. Typical responses to low bioavailable testosterone levels include:
Bone tissue is constantly being broken down and rebuilt. In an individual with osteoporosis, more bone tissue is lost than is regenerated. Testosterone is thought to play a role in helping to maintain this balance in men. Between the ages of 40 and 70 years, male bone density falls by up to 15 percent. Approximately one in eight men over age 50 actually have osteoporosis.
The incidence of hip fractures rises exponentially in aging men. About 20-30 percent of osteoporotic fractures occur in men and the incidence of fractures has been increasing.
Low bone density increases the risk of frequent fractures, associated pain, and in many cases, loss of function. Wrists, hips, spine and ribs are most commonly affected.
Consequences of osteoporosis include a slow but progressive rounding of the shoulders as well as a loss of height and back pain. When a hip fracture occurs, up to one third of patients never seem to regain full mobility.
It is now well accepted that a women’s risk of atherosclerosis increases after menopause and that estrogen replacement therapy reverses this trend. A similar phenomenon occurs in men as their testosterone levels diminish with age. Clinical research suggests an association between low testosterone levels and an increase in cardiovascular risk in men.