Symptoms of Andropause

The term andropause, or male menopause, is a fairly recent concept. This syndrome occurs as men age and levels of testosterone decline; see this article for more details. Interestingly, the symptoms of andropause closely mimic the general signs of aging.

These symptoms include a loss of energy, depression, decreased sex drive and erectile dysfunction, decreased muscle mass and increased fat mass, osteoporosis, and even cardiovascular risks.

Emotional Changes

Although many people think depression is just a part of aging, the National Institute of Mental Health remind us that depressive disorders are NOT a normal part of aging. Research suggests that one cause of depression as men age is a decrease in the amount of testosterone.

A testosterone deficiency can cause anxiety, fatigue, difficulty sleeping, forgetfulness, confusion, and a list of other symptoms indicating depression. Research has also shown that using testosterone replacement therapy can have an antidepressant effect on depressed patients with low testosterone levels. Although other causes for depression in older men do exists, there are strong indications that a hormone imbalance can play a major role.

Changes in Physique

Muscle loss coupled with gaining weight is another common symptom of andropause and, unfortunately, these two symptoms synergize to compound the problem. It is know that testosterone is important in building muscle mass and treating men deficient in testosterone with hormone replacement therapy does increase muscle mass and decrease fat levels.

In addition, depression and fatigue can exacerbate weight gain and muscle loss by decreasing motivation to exercise, be active, or even just get up and move around during the day. The resulting weight gain and loss of definition in muscles can further depression in men as their body image changes drastically.

Changes in Sexual Arousal

A lowered sex drive is probably the most commonly perceived symptom of low testosterone levels. Testosterone has long been known to have a positive effect on the male libido and sexual interest. In addition, erectile dysfunction is also a common symptom of testosterone deficiency. Again, treatment of andropause with hormone replacement therapy can also help restore lost sexual desire and may restore the ability to have and maintain an erection, suggesting that the hormone does play an important role in maintaining an active sex drive.

Risks for Disease

Current research suggests that a testosterone deficiency can increase your risks for certain diseases. In general, hormones play a role in many functions of your body and changes in a hormone can therefore affect each of those functions. Testosterone can be converted to two major hormones important for bone health: estradiol and dihydrotestosterone (DHT). These two hormones are vitally important to maintaining healthy bones by inhibiting bone resorption and the continuation of building bones. The loss of testosterone can consequently lead to osteopenia and osteoporosis.

In addition to osteoporosis, low testosterone levels are a risk factor for developing cardiovascular disease, metabolic syndrome, and type II diabetes. Although the exact mechanism for the increase risk of these diseases is not known, there are clear correlations and research to uncover the basis for this risk is ongoing.

Singularly, these various symptoms can be disturbing to anyone, but compounded together, these symptoms can play off of each other, causing a vicious cycle that further propagates the problem. These symptoms all have an adverse effect on quality of life but many men do not seek medical advice or treatment because they believe that it is only a side effect of aging. It is always important to discuss any concerns you may have about your health and well being with your doctor!

References

Testosterone and Depression. J Psychiatr Pract. 2009 Jul;15(4):289-305.

Measures of bioavailable serum testosterone and estrodiol and their relationships with muscle strength, bone density, and body composition in elderly men. J Clin Endocrinol Metab. 2000 Sep;85(9):3276-82.

Transdermal testosterone gell improves sexual function, mood, muscle strength and body composition parameters in hypogonadal men. J Clin Endocrinol Metab. 2000;85:2839–53.

Testosterone and ageing: what have we learned since the Institute of Medicine report and what lies ahead? International Journal of Clinical Practice. 2 Mar 2007: 61(4). 622-632