Hormone changes are a natural part of aging. Unlike the more dramatic reproductive hormone dips that occur in women during menopause, sex hormone changes occur gradually in men. Here’s what to expect and what you can do about it.
Underestimating the male menopause myth
The term “male menopause” is sometimes used to describe decreased testosterone levels due to aging. However, female menopause and male menopause are two different conditions.
In women, ovulation ends and hormone production drops for a relatively short period of time. In men, the production of testosterone and other hormones declines over many years, and the results are unclear.
So what’s the best way to call it male menopause? Many doctors use the term “andropause” to describe the hormonal changes associated with aging in men. Other terms include androgen deficiency of testosterone deficiency syndrome, aging male, and late onset male hypogonadism.
Understanding male hormones over time
Testosterone levels vary widely among men. In general, older men tend to have lower testosterone levels than younger men. Testosterone levels gradually decline into adulthood – on average around 1 percent per year after age 30.
Recognizing low testosterone levels
A blood test is the only way to diagnose low or low testosterone levels. Lower than normal testosterone level without signs or symptoms in some men. In this case, no treatment is required.
The recognizable sign and symptoms of low testosterone levels may include:
- Changes in sexual function. This includes decreased sexual desire, erectile dysfunction, less spontaneous erections – such as during sleep – and infertility. Your testicles may also shrink.
- Changes in sleep patterns. Sometimes, low testosterone causes sleep disturbances such as insomnia or increased sleepiness.
- Physical changes Various physical changes are possible, such as increased body fat, decreased muscle mass and strength, and decreased bone density. Swollen or tender breasts (gynecomastia) and body hair loss are possible. On rare occasions, you may experience hot flashes and have less energy.
- Emotional changes. Low testosterone can contribute to decreased motivation or self-confidence. You may feel sad or depressed, or have trouble concentrating or remembering things.
Some of these signs and symptoms can be caused by underlying factors other than low testosterone, such as medication side effects, thyroid issues, depression, and excessive alcohol use. There are also conditions such as obstructive sleep apnea that can affect testosterone levels. Once these conditions are identified and treated, testosterone will typically return to normal levels.
I feel your best
If you are experiencing signs and symptoms that could be the result of low testosterone levels, consult your doctor. He or she can evaluate possible reasons for the way you feel and explain treatment options.
You cannot increase your natural testosterone production, but these steps can help:
- Be honest with your doctor. Work with your doctor to identify and treat health issues that may be causing or contributing to your signs and symptoms, ranging from drug side effects to erectile dysfunction and other sexual issues.
- Make healthy lifestyle choices. Eat a healthy diet and add physical activity to your daily routine. Healthy lifestyle choices help you maintain strength, energy and lean muscle mass. Regular physical activity can improve your mood and promote better sleep.
- If you are upset, seek help. Men don’t always experience depression as a feeling of sadness. You may be unusually tired, anxious or angry – even angry – and have a hard time fulfilling your responsibilities at work and at home. Other common symptoms seen in men include difficulty sleeping and suicidal thoughts. Talk to your doctor if you think you may be depressed. There are many effective treatments available.
- Be careful about herbal supplements. Herbal supplements have not been proven to be safe and effective for low testosterone associated with aging. Even some supplements can be dangerous. Long-term use of DHEA, for example, has no proven benefits and may increase the risk of prostate cancer.
Treatment of aging-related low testosterone with testosterone replacement therapy is controversial.
For some men, testosterone therapy relieves bothersome symptoms and signs of testosterone deficiency. For others, the benefits are unclear and there are possible risks.
Testosterone therapy contributes to sleep apnea, stimulates non-cancerous growth of the prostate, and stimulates the growth of existing prostate cancer. Testosterone therapy can also increase the risk of heart attack and stroke and contribute to the formation of blood clots in the veins.
If you are wondering whether testosterone replacement is right for you, work with your doctor to determine why your testosterone level is low and whether it is causing your symptoms. Weigh the pros and cons of the treatment with your doctor.
