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Spotlight: Male Menopause—Is It Real?


The term “male menopause” has been in the news, making headlines now and then. The medical name for it is “andropause.” You may have wondered whether it is affecting yourself or a loved one.

The theory behind male menopause is that the levels of the hormone testosterone decrease with age, causing irritability, lack of strength and lack of sexual drive. It sounds logical, right? After all, women go through menopause when their hormone levels drop. And in fact, hormone replacement therapy (HRT), which women have been taking for years after they start menopause (although now we know more about the risks of HRT), does exist for men, although most experts agree that it’s appropriate only for a very few, specific reasons. There’s more about men and HRT at the end of this article.

Both women and men produce testosterone, but women produce smaller amounts of it. In men, it’s produced in the testes, which are the reproductive glands that also produce sperm. The hypothalamus and the pituitary gland determine how much testosterone your body produces.

During adolescence, testosterone production in men is at its peak. It gradually does decrease as men age. But the latest thinking among many researchers is that there’s very little evidence that most men experience a serious drop in testosterone levels. Remember, many men continue to be able to father children as they age. Many older men have testosterone levels that are in about the same range as healthy younger men.

Symptoms could be related to other health conditions

There are many conditions that develop as people age. Many people have one or two lifestyle-related habits that can lead to conditions that cause feelings of tiredness, stress and loss of strength. Years of smoking, drinking too much alcohol, weighing too much and getting too little physical exercise can contribute to high blood pressure, diabetes and cardiovascular disease, and also simply make you feel not nearly as healthy as you did when you were younger. Diabetes is a common reason for erectile dysfunction because of the circulatory problems that often accompany it.

Which men are most likely to need hormone replacement therapy?

There is hormone replacement therapy (HRT) for men, but most experts agree that until there’s more evidence that male menopause exists, HRT is appropriate only for men whose bodies make very little or no testosterone. These would include men whose pituitary gland has been destroyed by infection or tumors, or men whose testes have been damaged, for example.

Large clinical trials are necessary to determine the risks and benefits of HRT for men. It’s important for men to visit their doctors to find out the cause of lack of energy, lack of sexual drive, loss of strength or any of the other symptoms that some might think of as “male menopause.”

The Institute of Medicine; National Institute on Aging
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