What is andropause?

After age 40, men may experience a phenomenon similar to the female menopause called andropause, due to the gradual decline in testosterone level. However, the concept of andropause has been more controversial than the female menopause. One of the reasons is that menopause has a clear signpost marked by the cessation of menstruation, while andropause does not.

What are the causes?

Testosterone ("the male hormone") is a substance produced in the testes and in the adrenal glands that has a unique effect on a man's total body. The hormone helps to build protein and is essential for normal sexual behavior and produce erections. It also affects many metabolic activities such as production of blood cells in the bone marrow, bone formation, lipid metabolism, carbohydrate metabolism, liver function and prostate gland growth.

After age 30, testosterone levels drop by about 10 percent every decade. Andropause is associated with low testosterone level. Every man experiences a decline of bioavailable testosterone but some men's levels dip lower than others. And when this happens, these men may experience andropause symptoms.

What are the symptoms of andropause?

When there is less testosterone available to do its work, the testosterone target-organ response decreases, bringing about many changes. Since there is great variability in testosterone levels among healthy men, therefore not all men will experience the same changes to the same extent. But typical responses to low testosterone levels can be broadly classified into:

• General symptoms: such as increased body fat, decreased muscle mass and strength, loss of body height (due to osteoporosis) and loss of energy.
• Psychological symptoms: such as swinging mood, depression, anxiety, lack of vitality and sleep problems.
• Sexual and urinary symptoms: such as low sex drive, reduced rigidity, impotence and urinary problems (related to benign prostatic hyperplasia).

Is there anything I can do to prevent andropause?

It is a fact that decline in testosterone levels with increasing age occurs in all men. Some current studies suggest that smoking and high cholesterol level may increase the risks for early andropause. Therefore, you should quit smoking and target at better cholesterol level control for prevention. Regular exercise will also help to maintain the muscle and bone mass.

Andropause is part of a normal aging process. Most men can manage the changes smoothly when they have more understanding about the process and better psychological support. Testosterone replacement therapy may be considered if the symptoms are bothering them.

Doctor will check carefully by blood tests and physical examination for potential candidates of testosterone replacement therapy. The goal of testosterone replacement therapy is to minimize, prevent or reverse the effect of our age-related decline of testosterone. Administration of adequate testosterone may have the following benefits:

• improvement in libido and erectile function
• improvement in body composition (ratio of fat to lean muscle mass).
• improvement in bone density.
• improvement of cognitive function.

The options for testosterone replacement therapy include oral capsules, injection and skin patches. The therapy is shown to be highly effective at relieving andropause symptoms within 3-6 weeks.

There are two conditions in which testosterone replacement therapy should never be used. They are prostate cancer and breast cancer in male. In addition, there are several other conditions where this therapy may be unsuitable, such as liver and heart diseases. Testosterone can only be taken under the direction from your doctor. Self-treatment may result in serious side-effects, such as impotence and infertility.