HealthLine: Is Menopause Only in Women?

When one hears the word menopause, the idea of a woman trying to sit in her refrigerator to escape her hot flashes may come to mind.  Interestingly, there is widespread information coming to light about a suspected male menopause with its medical term of “andropause” and layman’s affectionate term of “man-opause.”

Some physicians define andropause as a decline in testosterone (androgen) in the aging male, a low testosterone state.  In contrast to women, who experience an abrupt drop in estrogen inducing the menopausal state with recognizable symptoms and loss of reproductive capability, men will experience a slow decline in their testosterone level and maintain their ability to reproduce, even in advanced years.  Testosterone declines 10% every decade after age 30, about 1% per year, so by about age 70, the decrease in a male’s testosterone level is as much as 50%. 

Since andropause is a gradual process, signs and symptoms may show at a slower rate than women.  Most commonly males will seek evaluation when they experience reduced sexual function, but sleep disturbances such as insomnia may be a subtle change that is overlooked.  Oftentimes partners of affected males will notice decreased motivation or self-confidence, depression or poor concentration and memory loss.  Andropause has also been correlated with Alzheimer’s Disease.

Physical symptoms can vary including increased body fat, reduced muscle bulk and strength, decreased bone density, swollen or tender breasts, hair loss and even hot flashes.  Similar signs and symptoms can be found with medication side effects, thyroid disease, depression and excessive alcohol intake.  These disease states must be investigated and eliminated before a male is considered in the andropausal state.

Premature andropause can occur in males in professions with exposure to high estrogen levels such as the pharmaceutical industry, plastic factories, near incinerators and on farms with pesticides.  Regardless of exposure, andropause is more likely to occur with concomitant diabetes, hypertension, sleep apnea and genetic disorders which cause hypogonadism, such as Klinefelter’s Syndrome.

The cornerstone of lab testing for andropause is the blood testosterone level.  If testosterone levels are low, testosterone supplementation may help relieve such symptoms as loss of interest in sex, depression and fatigue.  Decreased DHEA levels are also noted to occur in andropause, but replacement is not recommended.  Testosterone therapy has its own risk of side effects and may worsen prostate cancer.

It is best to talk to your doctor regarding the pros and cons of taking testosterone.  A good diet, regular exercise and antidepressants alone may be enough to alleviate symptoms in some patients.

So next time you see your husband or partner crying at the movies, waking up at 2 a.m. with night sweats or forgetting where he put his wrench in the garage, reassure him everything will be OK and make a Nordstrom Run.  He won’t remember you went anyway!

Dr. Ballard is a Board Certified Internist and Geriatrician with a special interest in Women’s Health.  She practices in Enumclaw, 360-825-1389.  Dr. Ballard’s comments are informational only and not to be construed as medical advice.  Consult your personal physician for any medical issues.