Andropause

Also known as: Male Menopause
What is it?
Andropause, or male menopause, is a condition associated with declining androgen levels. It may result from primary or secondary hypogonadism or from a pathologic condition.
Who gets it?
Andropause affects about half of men older than age 50.
What causes it?
Andropause is caused by lower levels of testosterone and its consequences as men age. Recent studies show that after age 30, testosterone levels generally decrease by one to two percent per year - although this decline can vary widely.
Sudden, drastic declines in testosterone levels are usually caused by hypogonadism. Classified as either primary or secondary, hypogonadism should be ruled out in patients experiencing symptoms of andropause.
What are the symptoms?
Symptoms of andropause can vary from one man to the next. Symptoms of male Andropause may include lethargy or decreased energy, decreased libido or interest in sex, erectile dysfunction with loss of erections, muscle weakness and aches, inability to sleep, hot flashes, night sweats, depression, infertility and thinning of bones or bone loss.
How is it diagnosed?
Andropause can be diagnosed by measuring the level of testosterone in the blood. Andropause occurs as a result of testosterone deficiency and a low free and bioavailable testosterone level is found in males with androgen deficiency. Total testosterone levels can be used as a screen for the Andropause but it is the decrease in the free form of testosterone that causes the symptoms.
Usually testosterone deficiency is not the most common cause of impotence; other causes include atherosclerosis, diabetes, hypertension, and use of certain medications. These factors, as well as previous genital trauma and other aspects of the patient’s medical history, are important in diagnosing andropause.
What is the treatment?
To treat andropause, the doctor may advise the patient to undergo hormone replacement therapy. Replacing testosterone can have a significant benefit particularly in older men with an improvement in well-being, improved sex drive, improved sexual function, improved muscle mass and strength and an increase in bone density. There are now several alternatives available for testosterone replacement therapy in the form of skin patches and creams that can deliver testosterone into the blood in a non-invasive way.
Men who are carefully selected for hormone replacement therapy must be monitored for signs of prostate disease, dyslipidemia, hepatotoxicity, erythrocytosis, and other side effects.
Consult your physician and ask her/him whether you should have a testosterone level determined to see if you are deficient. If you are deficient and are a candidate for testosterone replacement therapy, your physician will prescribe just the right therapy for you. Questions can be directed to the Endocrine Clinic here at Penn State Hershey Medical Center.
Self-care tips
Patients diagnosed with andropause and being treated with hormone replacement therapy should be monitored to check testosterone, lipid and hematocrit levels. That way, treatment can be adjusted according to the patient’s needs and side affects closely monitored