About male menopause
What is male menopause?
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.
What are the symptoms for male menopause?
Male menopause can cause physical, sexual, and psychological problems. They typically worsen as you get older. They can include:
- low energy
- depression or sadness
- decreased motivation
- lowered self-confidence
- difficulty concentrating
- insomnia or difficulty sleeping
- increased body fat
- reduced muscle mass and feelings of physical weakness
- gynecomastia, or development of breasts
- decreased bone density
- erectile dysfunction
- reduced libido
You may also experience swollen or tender breasts, decreased testicle size, loss of body hair, or hot flashes. Low levels of testosterone associated with male menopause have also been linked to osteoporosis. This is a condition where your bones become weak and brittle. These are rare symptoms. They typically affect men at the same age as women entering menopause.
What are the causes for male menopause?
Before you hit puberty, your testosterone levels are low. Then they increase as you sexually mature. Testosterone is the hormone that fuels typical changes involved in male puberty, such as:
- growth of your muscle mass
- growth of your body hair
- lowering of your voice
- changes in your sexual functioning.
As you age, your testosterone levels will typically begin to drop. Testosterone levels tend to decline an average of 1 percent per year after men turn 30. Some health conditions can cause earlier or more drastic declines in your testosterone levels.
What are the treatments for male menopause?
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.
What are the risk factors for male menopause?
The two basic types of hypogonadism are primary and secondary hypogonadism.
Underactive testes cause primary hypogonadism. That’s because they don’t manufacture sufficient levels of testosterone for optimal growth and health. This underactivity can be caused by an inherited trait. It can also be acquired by accident or illness.
Inherited conditions include:
- Undescended testicles: When the testicles fail to descend from the abdomen before birth
- Klinefelter’s syndrome: A condition in which a man is born with three sex chromosomes: X, X, and Y.
- Hemochromatosis: Too much iron in the blood causes testicular failure or pituitary damage
Types of testicle damage that can lead to primary hypogonadism include:
- Physical injury to the testicles: Injury must occur to both testicles to affect testosterone levels.
- Mumps orchitis: A mumps infection can injure testicles.
- Cancer treatment: Chemotherapy or radiation can damage testicles.
Secondary hypogonadism is caused by damage to the pituitary gland or hypothalamus. These parts of the brain control hormone production by the testes.
Inherited or disease conditions in this category include:
- Pituitary disorders caused by drugs, kidney failure, or small tumors
- Kallmann syndrome, a condition connected to abnormal hypothalamus function
- Inflammatory diseases, such as tuberculosis, sarcoidosis, and histiocytosis, which can impact the pituitary gland and the hypothalamus
- HIV/AIDS, which can affect the pituitary gland, hypothalamus, and testes
Acquired circumstances that can lead to secondary hypogonadism include:
- Normal aging: Aging affects production and response to hormones.
- Obesity: High body fat can affect hormone production and response.
- Medications: Opioid pain meds and steroids can affect function of the pituitary gland and hypothalamus.
- Concurrent illness: Severe emotional stress or physical stress from an illness or surgery can cause the reproductive system to temporarily shut down.
You may be affected by primary, secondary, or a mixed hypogonadism. Mixed hypogonadism is more common with increased age. People undergoing glucocorticoid therapy can develop the condition. It also can affect people with sickle-cell disease, thalassemia, or alcoholism.
Is there a cure/medications for male menopause?
It’s normal to experience a decline in your testosterone levels as you get older. For many men, the symptoms are manageable, even without treatment. If your symptoms are causing you hardship, speak to your doctor. They can provide recommendations to help you manage or treat your symptoms.