Hormone changes are a natural part of aging. Unlike the more dramatic reproductive hormone plunge that occurs in women during menopause, however, sex hormone changes in men occur gradually. Here's what to expect, and what you can do about it.
The term "male menopause" is sometimes used to describe decreasing testosterone levels related to aging. Female menopause and so-called male menopause are two different situations, however.
In women, ovulation ends and hormone production plummets during a relatively short period of time. In men, production of testosterone and other hormones declines over a period of many years and the consequences aren't necessarily clear.
So what's the best way to refer to so-called male menopause? Many doctors use the term "andropause" to describe aging-related hormone changes in men. Other terms include testosterone deficiency syndrome, androgen deficiency of the aging male and late-onset male hypogonadism.
Testosterone levels vary greatly among men. In general, older men tend to have lower testosterone levels than do younger men. Testosterone levels gradually decline throughout adulthood — about 1 percent a year after age 30 on average.
A blood test is the only way to diagnose a low or reduced testosterone level. Some men have a lower than normal testosterone level without signs or symptoms. In this case, no treatment is needed.
Recognizable signs and symptoms of low testosterone levels may include:
- Changes in sexual function. This might include reduced sexual desire, erectile dysfunction, fewer spontaneous erections — such as during sleep — and infertility. Your testes might become smaller as well.
- Changes in sleep patterns. Sometimes low testosterone causes sleep disturbances, such as insomnia, or increased sleepiness.
- Physical changes. Various physical changes are possible, including increased body fat, reduced muscle bulk and strength, and decreased bone density. Swollen or tender breasts (gynecomastia) and loss of body hair are possible. Rarely, you might experience hot flashes and have less energy.
- Emotional changes. Low testosterone might contribute to a decrease in motivation or self-confidence. You might 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, including medication side effects, thyroid problems, depression and excessive alcohol use. There also are conditions such as obstructive sleep apnea that might affect testosterone levels. Once these conditions are identified and treated, testosterone typically will return to a normal level.
If you are experiencing signs and symptoms that might be the result of a low testosterone level, consult your doctor. He or she can evaluate possible causes for the way you feel and explain treatment options.
You can't boost your natural testosterone production, but these steps might help:
- Be honest with your doctor. Work with your doctor to identify and treat any health issues that might be causing or contributing to your signs and symptoms — from medication side effects to erectile dysfunction and other sexual issues.
- Make healthy lifestyle choices. Eat a healthy diet and include physical activity in your daily routine. Healthy lifestyle choices will help you maintain your strength, energy and lean muscle mass. Regular physical activity can even improve your mood and promote better sleep.
- Seek help if you feel down. Men don't always experience depression as feelings of sadness. You may be unusually tired, anxious or irritable — even angry — and you may have trouble keeping up with your responsibilities at work and home. Other common symptoms in men include difficulty sleeping and thoughts of suicide. Talk with your doctor if you think you might be depressed. Many effective treatments are available.
- Be wary of herbal supplements. Herbal supplements haven't been proved safe and effective for aging-related low testosterone. Some supplements might even be dangerous. Long-term use of DHEA, for example, has no proven benefits and might increase the risk of prostate cancer.
Treating aging-related low testosterone with testosterone replacement therapy is controversial.
For some men, testosterone therapy relieves bothersome signs and symptoms of testosterone deficiency. For others, the benefits aren't clear and there are possible risks.
Among the risks, testosterone therapy contributes to sleep apnea, stimulates noncancerous growth of the prostate and stimulates growth of existing prostate cancer. Testosterone therapy may also increase the risk of heart attack and stroke and contributes to the formation of blood clots in the veins.
If you wonder whether testosterone replacement might be 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 treatment together with your doctor.