September 20, 2019

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“… male menopause may be life-changing enough for a man to make an appointment with his physician …”

Andropause is the menopause equivalent for men, but men beware; fatigue is just the tip of the iceberg 

While all older women go through a defined time in their lives known as menopause — the abrupt drop-off of reproductive hormones signifying the end of their period and fertility — men face a more gradual reduction in sexual hormones as they age. After about the age of 55, there is a slow decline in natural testosterone in a man’s body, according to Dr. Omer A. Raheem, director of the Men’s Health Center at Tulane Urology and assistant professor at the Tulane University Department of Urology.

The term for the collection of symptoms caused by this decline in a man’s testosterone levels is called andropause. While it may not be considered a well-defined stage like the menopause all women endure, symptoms of andropause, or what has been dubbed “male menopause,” may be life-changing enough for a man to make an appointment with his physician — or have his wife do it for him.

Pay Attention to Symptoms

Symptoms of andropause include weight gain, lack of motivation or energy, a reduced sex drive or libido, and erectile disfunction. The drop in testosterone also has implications on heart and bone health in men.

While many men experience some of these symptoms, male menopause just isn’t discussed as often as female menopause. Raheem likens the secrecy of male menopause to men’s health in general. Men just aren’t as likely to talk to other male friends, or even their wives, about health concerns.

“They don’t want to share their inner problems,” he says. “They don’t want to open up to their partners or wives or even their doctors.”

Men often have the “if it’s not broken, don’t fix it” mentality, and they typically won’t admit to health problems until they become too big to ignore. Women are more likely to be vocal and seek medical advice early. 

Raheem urges men to consult their physician or a specialist if they are experiencing these symptoms to have their testosterone levels checked. To check testosterone levels, a patient should have blood work done early in the morning. Testosterone levels are considered low when levels fall below 300 nanograms per deciliter, but only having low testosterone, often called low-T, doesn’t mean a man is experiencing andropause, Raheem says.

“What we look for is a combination of symptoms and signs,” he says. If symptoms are present and numbers are low, “You, in my book, qualify for treatment.” 

Andropause Treatment

An easy first step in trying to eliminate these uncomfortable symptoms without medication is physical activity. Raheem recommends exercising 20 minutes, five days a week. Cardio exercise that raises your heart level, like swimming or even walking the dog, can improve a man’s physical performance and ease symptoms.

If you’re exercising plenty and are still having symptoms, there is medication that physicians can prescribe that produces and stimulates the production of testosterone. Some of the medicines Raheem describes include testosterone replacement therapy in the form of creams or gels; other forms come as injectables or testosterone pellets implanted under the skin. Inhibitors like anastrozole increase testosterone production while reducing the production of estrogen, according to Raheem.

It is important to note that these medications, which should be prescribed by a men’s health specialist, do have side effects. These side effects include increased blood levels, increased fluid in the body, and more serious risks of stroke and heart attack.

Raheem urges men to pay attention to their physical health and get enough exercise as they age.

Kate Stevens is a freelance writer and frequent contributor to our sister publication, Nola Family.