Is Male Menopause Real?

Hormonal changes can affect men physically and emotionally

An older African-American man discusses symptoms of male menopause, another name for low-testosterone, with his physician.

Hormonal changes can affect men physically and emotionally

Menopause is often associated with hot flashes and mood swings in women. So, do hormonal changes with similar symptoms occur in men as they age? Is male menopause a real medical issue?

The answer is yes. But male menopause is just one easy way to describe it.

Male menopause is a condition that affects older men. It carries a set of symptoms that are linked to declining testosterone levels and aging. It is also referred to as andropause, androgen decline in the aging male, late onset hypogonadism and low testosterone.

“Not every man will experience this. But the symptoms are very real,” says Luigi Simone, MD, a family medicine physician at Scripps Clinic Encinitas with a special focus on men’s health. “There’s a reason it’s called male menopause. It’s because it can produce many of the same symptoms as female menopause.”

Those symptoms include irritability, weight gain, low sex drive and function, problems sleeping, depression, fatigue and loss of strength. It may even include hot flashes. These symptoms in many cases may have nothing to do with testosterone deficiency, but with other conditions.

To diagnose low testosterone, a health care provider conducts a physical exam, reviews medical history, and orders blood tests.

Why do men experience low testosterone?

Testosterone is the hormone responsible for the development of male sexual characteristics. It’s normal for levels to decline in men as they age. After 40, levels begin to decline by about 1 percent every year.

The rate of testosterone deficiency can be affected by chronic disease, such as obesity, diabetes, and medication. These are health conditions that can be caught in their early stages during routine medical exams, which increases the chances of successful treatment.

A decline in testosterone and symptoms that may arise are gradual compared to what women experience during menopause.

“These midlife changes are often more subtle in men than in women,” says Dr. Simone. “Women experience a complete shutdown of ovarian hormone production at menopause. The decline in testosterone in men is slow.”

Male menopause symptoms

A gradual decline of testosterone is a normal part of aging. But an unusually low level of testosterone could mean it is male menopause. Other symptoms include:

  • Erectile dysfunction, or inability to achieve or sustain an erection
  • A decreased sex drive and infertility
  • Depression, fatigue, insomnia
  • Increased body fat, reduced muscle mass and decreased bone density.

These symptoms may also occur in older males with heart disease, obesity, high blood pressure and type 2 diabetes. Physicians can order tests to rule out any medical problem that may be contributing to these symptoms.

What does a blood test do?

A blood test can confirm whether a man has low testosterone and if treatment is needed. Treatment options may include testosterone replacement therapy. This may help relieve symptoms, such as loss of sex drive, fatigue and depression.

If you are considering replacement therapy, make sure to discuss the potential risks and side effects with your doctor. Replacing testosterone, for example, may worsen prostate cancer and increase the risk of heart disease.

Lifestyle changes

Your doctor may very well recommend certain lifestyle or other changes to help with some of the symptoms of male menopause.

“I encourage every man to ask his doctor about ways to manage stress, optimize health and enjoy life to its fullest,” Dr. Simone says.

“There are so many things men can do at home as well,” he adds. “Good health is not just about eating right and getting exercise. It’s just as important to have a good laugh, enjoy some alone time and connect with friends. Having sex is also good for your mind and body because it relieves stress and helps to keep your prostate healthy.”

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