Are you at risk for male menopause? If you’re thinking of finding out with Google, don’t, that is, unless you’re looking for an overwhelming volume of advice and endless tips for ‘treating’ the problem. But if you do, look a little deeper and you will find that male menopause, often called andropause, is actually quite controversial. Many health experts argue that there is no such thing. In that case, could you be experiencing it? How would you know? And what could be done about it?
We experience hormone changes naturally as part of aging. Remember the ‘rush’ of teen hormones? Well, this is the other end of that same stick. Among women, the drop in hormone levels that occurs during menopause is quite dramatic and relatively fast. As soon as ovulation ends, hormone production just plummets, but in men, changes in testosterone occur more gradually, over many years usually. And the consequences are not nearly as clear.
Research suggests that roughly two out of five men aged 40 or older experience symptoms that identify as due to lower testosterone. These include various levels of fatigue or lethargy, depression, increased irritability, mood swings, a decrease in lean muscle and an increase in fat. It may also lead to lower levels of libido and difficulty in attaining and sustaining an erection.
These physical and emotional changes could well be the result of decreased levels of the male hormone testosterone. Or they could just be symptoms of other problems such as stress, diabetes or any number of other medical reasons. The reduction of testosterone production in men is simply not parallel to that experienced in menopause, so, there is a great deal of skepticism about andropause. There is much debate about whether or not men really do go through a well-defined male menopause.
The only way to diagnose a low testosterone level is by blood test. But there is significant variability between men so one man’s low testosterone may simply be average for another. Some men have a lower than normal testosterone level without signs or symptoms. In this case, no treatment is called for.
The ‘problem’ of low testosterone may owe more to treatment opportunities than to an actual physical problem. It even has a catchy name: Low-T! Naturally, this leads to Testosterone Replacement Therapy. As expected, treating aging-related low testosterone with testosterone replacement therapy is controversial. There are benefits for some men for whom it will relieve bothersome symptoms. For others, however, the benefits are not clear — and there may be risks including a higher risk of heart attack, prostate cancer or other health problems.
If you are debating whether you have ‘Low-T’ and wondering if you need testosterone replacement, the best thing you can do is to chat about it with your doctor. Only then will you be properly equipped to make an informed decision.
Written by Dr. Paul Martiquet, Medical Health Officer for Rural Vancouver Coastal Health including Powell River, the Sunshine Coast, Sea-to- Sky, Bella Bella and Bella Coola.