The andropause corresponds to the fall of the testosterone level in men. What are the consequences? How can you recognise the symptoms? What is it due to? Can it be prevented? Or even treat it? Here are our explanations.
What does andropause mean?
Andropause, from the Greek andros, meaning “man”, and pausis, meaning “cessation”, is often presented as the male counterpart of the menopause. It is defined as the set of physiological and psychological symptoms that may accompany the decline of testosterone in men, usually between the ages of 45 and 65.
Andropause is not a medically recognised syndrome. However, it reflects a current reality as more and more middle-aged men are choosing to undertake testosterone treatment.
This treatment has been used for many years in young men with inborn hypogonadism, i.e. in whom the production of sex hormones by the gonads or testes is abnormally low due to a genetic problem. However, it is recently being offered to healthy middle-aged men.
The symptoms of andropause include
- a decrease in sexual appetite ;
- the onset of erectile problems;
- a feeling of running out of energy and drive;
periods of excessive sweating;
- problems with insomnia;
- weight gain.
Considered a dysfunction by some, or a reflection of normal aging by others, andropause remains a controversial topic. What’s more, the only medication available, testosterone, is unproven, either in terms of effectiveness or safety.
Menopause for some, andropause for others?
The comparison between andropause and menopause is rather lame. Andropause affects only a minority of men. Also, it does not mark the end of fertility. Moreover, the hormonal decline in men is partial, gradual and inconsistent, unlike in women, where hormones fall sharply over a short period.
In men, a slight decline in testosterone production is thought to begin in their thirties or forties. According to what experts have observed, the concentration of testosterone in the blood decreases by about 1% per year.
Is it really a question of testosterone?
Testosterone has been offered as a treatment for andropause for over 20 years. The aim of the treatment is to improve the quality of life by reducing symptoms.
Pharmaceutical companies claim that testosterone may also delay the aging process:
- less loss of muscle mass ;
- less risk of fractures;
- more sexual vigour, including better erections, etc.
However, these effects have not been scientifically proven.
The main factors that make the treatment of andropause a delicate and complex subject are:
- The level of testosterone that reflects “insufficiency” in middle-aged men is unknown. Moreover, this level varies from one man to another. The scales currently in use have a high degree of imprecision and are based on averages in young men;
- There are no specific symptoms of andropause. In other words, any symptoms experienced may be the consequence of other health problems, such as depression, vascular problems or obesity;
- The association between low testosterone levels and andropause symptoms is weak, according to various studies. The association between low testosterone and andropause symptoms is weak, according to various studies. Men with testosterone levels considered normal may experience andropause symptoms. Some experts believe that andropause symptoms are more often the result of poor lifestyle habits.2,11
- The benefits and risks of testosterone treatment are not clearly established by clinical trials, either in the short or long term. Some experts claim that hormone therapy with testosterone is an expensive placebo12. The main concern with testosterone therapy in older men is an increased risk of prostate cancer or stroke. This is because testosterone increases haemoglobin levels and may slightly alter the lipid profile of the blood, increasing the risk of a blood clot forming in an artery in the brain.
Other risks include
- liver damage ;
- breast development which may become painful
- atrophy of the testicles;
- increased aggressive or anti-social behaviour;
- aggravation of an existing health condition such as sleep apnea, mania, depression, etc.
As with hormones prescribed to menopausal women, it may be discovered after the fact that this testosterone treatment presents certain health risks. Studies are underway.
Other hormonal changes could explain the effects of andropause. DHEA or dehydroepiandrosterone, growth hormone, melatonin and, to a lesser extent, thyroid hormones also have an influence
Testosterone is the most important sex hormone in men. It is associated with vitality and virility. It is responsible for the appearance of male sexual characteristics at puberty.
It also helps to maintain healthy bones and firm muscles and stimulates the production of sperm and red blood cells. The way fat accumulates on the body is also influenced by this hormone. Women also produce it, but in very small quantities.
Testosterone is produced by the testicles. The amount of testosterone produced depends on signals from glands in the brain, namely the hypothalamus and pituitary gland.
Various factors will promote or inhibit testosterone production. Sexual intercourse, for example, stimulates it. Once produced, testosterone circulates through the bloodstream and binds to receptors in various tissues, where it exerts its effects.
Taking TestoUltra is also a good way to stimulate it and improve level: TestoUltra Original.
Andropause: who is affected?
Since andropause is little known and rarely detected, there is no exact data on the proportion of men who suffer from it.
Nevertheless, according to a large study, the European Male Aging Study, only 2% of men aged between 40 and 80 experience andropause. The proportion is 3% in the 60 to 69 age group and 5% in the 70 to 79 age group1. According to the authors of the study, these results indicate that testosterone treatment is suitable for very few men12.
According to the authors of the study, these results indicate that testosterone treatment is suitable for very few men.12 Most of the time, according to their observations, the symptoms are rather related to:
- ageing ;
- obesity ;
- another health problem.
In fact, 20-40% of men are thought to develop andropause-like symptoms as they age.
Andropause: how is it diagnosed?
As the treatment of andropause is recent, the criteria for diagnosis are not based on a solid scientific foundation.
The doctor first asks about the symptoms experienced by the patient. He can use certain evaluation forms to better depict the intensity of the symptoms, such as :
AMS test for Aging Male Score ;
the ADAM test for Androgen Deficiency of the Aging Male.
According to the International Society for the Study of Aging Male or ISSAM, tests to measure testosterone levels in the blood should be part of the diagnosis since symptoms may not be related to andropause3. However, these tests are only performed if more than one symptom is present.
Total testosterone level
The result of this test includes both testosterone bound to a transporter called sex hormone binding globulin or SHBG and, to a lesser extent, albumin, and testosterone that circulates freely in the blood.
Free testosterone level
This is an important measure as it is the free testosterone that is active in the body. On average, about 2% of testosterone circulates freely in the blood.
There is no test that directly measures the level of free testosterone. Doctors therefore make an estimate by calculation: they measure the SHBG level in the blood and then subtract it from the total testosterone level.