Understanding Andropause: The Rise in Awareness of Male Testosterone Decline

Everyone is familiar with menopause, but the male counterpart, known as andropause, is often overlooked. Men also experience hormonal changes with age, leading to a gradual decline in testosterone levels starting around age 30. Unlike menopause, where estrogen drops sharply between 45 and 55, andropause involves an uneven and slow decrease in testosterone, a condition some experts refer to as acquired hypogonadism in aging men.

Dr. Hélène Lavoie, an endocrinologist at Université de Montréal, emphasizes that andropause is not a disease but a natural part of aging that might require intervention if it causes clinical symptoms. She cautions against misconceptions that equate andropause directly with menopause, pointing out that only 2% of hypogonadism cases are solely age-related. External factors such as diabetes, obesity, stress, depression, medication use, and pituitary disorders often contribute to testosterone reduction.

Detecting a problematic testosterone decline is complex, as hormones like luteinizing hormone (LH) and follicle-stimulating hormone (FSH) are released in pulses and sensitive to external influences. Proper diagnosis involves repeated blood tests and comprehensive evaluation rather than reliance on a single measurement. Men presenting symptoms like reduced libido, erectile dysfunction, loss of morning erections, fatigue, irritability, or muscle loss should seek medical advice for further assessment.

Treatment decisions are made cautiously, as current therapies like testosterone injections or gels provide modest benefits and carry potential risks. Lavoie warns against unnecessary testosterone use, especially in young men seeking muscle growth or beard development due to social pressures and the risk of irreversible fertility issues.

Lifestyle factors often influence testosterone levels; men approaching retirement may see improvements after lifestyle changes such as increased exercise, better sleep, and stress management. For some, hormone therapy may be temporary, with regular re-evaluation to determine ongoing need.

Ultimately, awareness of andropause is increasing, but medical professionals must distinguish between natural aging and pathological conditions to provide appropriate care. Open discussions about sexual health and hormonal changes are vital in addressing these issues responsibly.