Tired? Not interested in sex? Mister, you might be in andropause

Sonja Isger, Edmonton Journal 



Christopher Furlong / Getty Images

Is male menopause a true medical condition or just a good punchline when you're fifty-something and not feeling quite yourself?

You know, "Oh, that male menopause must've kicked in."


My middle-aged male editor wanted to know.

No punchlines here, my friend, er, boss.

There is such a thing as male menopause (though technically the name is all wrong -- but we'll get to that).

The hormonal change is real and so are a multitude of symptoms that can accompany it -- from a loss in libido or erectile dysfunction to fatigue or depression. And, yes, sometimes even night sweats.

Every woman who lives long enough will experience menopause -- a (permanent) pause in her menstrual cycle that signals the end to the steady stream of the hormone estrogen her body makes. Hence the name menopause.


Conversely, the hormone faucet in men never turns off. But the flow of testosterone does begin to gradually decrease at a rate of about one per cent a year beginning at age 30.


While some call it male menopause, doctors often call these age-related hormone changes in men "andropause" -- from the word androgen, a term to describe hormones such as testosterone.

How common is it?

It's unclear how many men develop andropause. A study of more than 3,000 European men published in the June 17 issue of The New England Journal of Medicine suggests the number is only perhaps two per cent of the population.

Anecdotally, some doctors say that number seems low. "It's certainly higher than that one study would suggest," said Dr. Lawrence Hakim, chairman of the Department of Urology at the Cleveland Clinic in Weston, Fla.


Diagnosis is a challenge



How low is low testosterone? It depends who you ask.

Studies have defined low testosterone in men as 250 nanograms per decilitre, while others cite 300. Men in their 20s and 30s typically have testosterone levels in the 600 range.

But a low number by itself is not enough.



For that guy, Castle says, you have to look closer, for erectile dysfunction, reduced sex drive, fewer morning erections. Doctors also often look for fatigue, problems walking long distances, bending or stooping.

And even if you have low testosterone and you're tired, your problem could be something else entirely -- diabetes, thyroid issues, a side-effect from medication or alcohol abuse.

Hormone therapy poses risks


"But over the last 10 years, the emerging evidence is that this may not just be a quality-of-life issue because they can't get erections," Castle said. "Now we think it could be a health issue as well."



And just as women must consider the risks of hormone therapy, so should men. Testosterone therapy could contribute to sleep apnea, put you at greater risk for heart disease, cause skin problems or stimulate the growth of existing prostate cancer.



Signs and symptoms

Some men have lower-than-normal testosterone without signs or symptoms. But others may experience:

Changes in sexual function: Can mean less desire, fewer spontaneous erections, erectile dysfunction

Changes in sleep patterns: For example, insomnia

Physical changes: More fat, less muscle bulk and strength, swollen or tender breasts, hair loss, less energy or hot flashes

Emotional changes: Feeling sad or depressed, difficulty concentrating or remembering things

Source: the Mayo Clinic

