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What is Andropause?
By the time men are between the ages of 40 and 55, they can experience a phenomenon similar to the female menopause, called andropause. Unlike women, men do not have a clear-cut signpost such as the cessation of menstruation to mark this transition. Both, however, are distinguished by a drop in hormone levels. Estrogen in the female, testosterone in the male. The bodily changes occur very gradually in men and may be accompanied by changes in attitudes and moods, fatigue, a loss of energy, sex drive and physical agility.
What's more, studies show that this decline in testosterone can actually put one at risk for other health problems like heart disease and weak bones. Since all this happens at a time of life when many men begin to question their values, accomplishments and direction in life, it's often difficult to realise that the changes occurring are related to more than just external conditions.
A gradual hormonal decline
Unlike menopause, which generally occurs in women during their mid-forties to mid-fifties, men's "transition" may be much more gradual and expand over many decades. Attitude, psychological stress, alcohol, injuries or surgery, medications, obesity and infections can contribute to its onset.
Although with age, a decline in testosterone levels will occur in virtually all men, there is no way of predicting who will experience andropausal symptoms of sufficient severity to seek medical help. Neither is it predictable at what age symptoms will occur in a particular individual. Each man's symptoms may be also different.
Is this a new phenomenon?
Yes and no. In fact, andropause was first described in medical literature in the 1940's. So it's not really new. But, our ability to diagnose it properly is. Sensitive tests for bioavailable testosterone weren't available until recently, so andropause has gone through a long period where it was underdiagnosed and undertreated. Now that men are living longer, there is heightened interest in andropause and this will help to advance our approach to this important life stage which was identified so long ago.
Increased diagnostic capability
Another reason why andropause has been underdiagnosed over the years is that symptoms can be vague and can vary a lot among individuals. Some men find it difficult to admit that there's even a problem. And often physicians didn't always think of low-testosterone levels as a possible culprit. So these factors often led doctors to conclude that symptoms were related to other medical conditions (i.e. depression) or were simply related to ageing and often encouraged their patients to accept that "they were no longer spring chickens".
This situation is changing. New blood testing methods are available and there is an increased interest in mens' ageing among medical researchers. So much attention is being focused on andropause that major efforts are underway to quickly share emerging scientific information with the international medical community.
Causes
Starting at about age 30, testosterone levels drop by about 10 percent every decade. At the same time, another factor in the body called Sex Binding Hormone Globulin, or SHBG, is increasing. SHBG traps much of the testosterone that is still circulating and makes it unavailable to exert its effects in the body's tissues. What's left over does the beneficial work and is known as "bioavailable" testosterone.
Andropause is associated with low (bioavailable) testosterone levels. Every man experiences a decline of bioavailable testosterone but some men's levels dip lower than others. And when this happens these men can experience andropausal symptoms.
These symptoms can impact their quality of life and may expose them to other, longer-term risks of low-testosterone. It is estimated that 30 percent of men in their 50s will have testosterone levels low enough to be causing symptoms or putting them at risk.
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