What is Andropause?
Andropause or male menopause is a name that has been given to a menopause-like condition in aging men. This relates to the slow but steady reduction of the production of the hormones testosterone and dehydroepiandrosterone in middle-aged men, and the consequences of that reduction, which is associated with a decrease in Leydig cells.
Since men do not go through a well-defined period referred to as menopause, some physicians refer to this problem as androgen (testosterone) decline in the aging male. Men do experience a decline in the production of the male hormone testosterone with aging, but this also occurs with some disease states such as diabetes. Along with the decline in testosterone, some men experience symptoms such as fatigue, weakness, depression, and sexual problems. The relationship of these symptoms to the decreased testosterone levels is still controversial.
Unlike menopause in women which represents a well-defined period in which hormone production stops completely, male hormone (testosterone) decline is a slower process. The testes, unlike the ovaries, does not stop making testosterone. In addition to testosterone, the testes of a healthy male may be able to make sperm well into his eighties or longer.
However, as a result of disease, subtle changes in the function of the testis may occur as early as 45 to 50 years of age, and more dramatically after the age of 70 in some men.
Unlike "menopause", the word "andropause" is not currently recognized by the World Health Organization and its ICD-10 medical classification. This is likely because "andropause" is a term of convenience describing the stage of life when symptoms of aging appear in men. While the words are sometimes used interchangeably, hypogonadism is a deficiency state in which the hormone testosterone goes below the normal range for even an aging male.
Andropause and Mid-Life Crisis
There is no doubt that a man's sexuality changes with advancing age. The instant, anytime, 'as-many-times-as-you-want' erections that are more the rule than the exception at 18, do not last forever. With advancing age, the urge reduces, erections take time to come on, any time is not always a good time and the penis requires more direct stimulation in order to get aroused. Besides, the erections may not be as angled and rigid, and ejaculation becomes feebler. The refractory period (interval) between erections gets prolonged.
Is all this because of the maturation (maturity) process? Is it because by middle age man has had enough sex so as not to be unnaturally preoccupied with it any longer? Is this because his wife has aged a bit and is no longer as attractive/ interested as before? Or is it because of the pressures at the work-place, the demands of parenthood, or pre-occupation with the lives of grown-up children and aging parents?
Is there really something called a middle-age crisis? If so, how is it different from male menopause?
Yes, there is something known as a mid-life crisis. This is often a time in a man's life when stability has been achieved and the struggles that were once a large part of life are now at an end. This new awareness that a life change has taken place can sometimes trigger a crisis. For some men, new-found stability may signify an end to vitality or youth. Many men find that after spending a lifetime working towards the goals of family and peers, the end result is unfulfilling. This is also often a time of change. Major shifts in career, marriage and parenting often occur during this time period. And, along with the physical signs of aging comes a realization of impending old age, retirement and eventually death. This time of life will only become a crisis if the changes become too difficult to cope with.
Mid-life crisis, thus, is essentially a problem of psycho-social adjustment. It need not necessarily have a bearing on a man's sex life. It is thus not synonymous with the andropause although there is frequently a superimposition of male menopausal factors in middle-aged men going through crises and this makes the picture hazy.
Andropause as Concept
Proponents of andropause as a distinct condition claim that it is a biological change experienced by men during mid-life, and often compare it to female menopause. Menopause, however, is a complete cessation of reproductive ability caused by the shutting down of the female reproductive system. Andropause is a decline in the male hormone testosterone. This drop in testosterone levels is considered to lead in some cases to loss of energy and concentration, depression, and mood swings. While andropause does not cause a man's reproductive system to stop working altogether, many experience bouts of impotence.
Andropause is usually caused by a very gradual testosterone deficiency and an increase in sex hormone-binding globulin (SHBG) that occurs from age 35 onwards. By contrast, women have a sudden onset of menopause around age 51. Testosterone declines 10% every decade after age 30 (1% per year).
Some of the current popular interest in the concept of andropause has been fueled by the book Male Menopause, written by Jed Diamond, a lay person. According to Diamond's view, andropause is a change of life in middle-aged men, which has hormonal, physical, psychological, interpersonal, social, sexual, and spiritual aspects. Diamond claims that this change occurs in all men, generally between the ages of 40 and 55, though it can occur as early as 35 or as late as 65. The term "male menopause" may be a misnomer, as unlike women, men's reproductive systems do not cease to work completely in mid-life; some men continue to father children late into their lives (at age 90 or older). But Diamond claims that, in terms of other life impacts, women’s and men’s experience are somewhat similar phenomena.
The concept of andropause is perhaps more widely accepted in Australia and some parts of Europe than it is in the United States.
Many clinicians believe that andropause is not a valid concept, because men can continue to reproduce into old age. Their reproductive systems do not stop working completely, and therefore they do not exhibit the sudden and dramatic drops in hormone levels characteristic of women undergoing menopause. In some men before the age of 60 there is a complete loss of libido, erectile function, and orgasmic ability.
Others feel that andropause is simply synonymous with hypogonadism or low testosterone levels. There is opposition to the concept of andropause in Europe as well as the U.S.
Some clinicians argue that many of the cited symptoms are not specific enough to warrant describing a new condition. For example, people who are overweight may be misguided into treating a new illness rather than addressing the lifestyle that led to their being overweight. Similarly, energy levels vary from person to person, and for people who are generally inactive, energy levels will automatically be lower overall.
While it is true that active and otherwise healthy men could in theory develop andropause-like symptoms, how common and widespread the phenomenon is, and whether genetics, lifestyle, environment, or a combination of factors are responsible, is not yet known.
Since the symptoms seem like nothing more than a more rapid than normal aging process, few researchers have looked into it. Though the condition was discovered in the 1940s and became official in medical literature in 1952, it has never seemed severe enough to warrant a place in the collective consciousness.
However, andropause, now matter how valid the concept from the official science point of view, undoubtedly affect significantly lives of men, in multiple aspects. In this blog, we will try to review available information on the topic and navigate through the complex ageing male process to define ways and methods to slow down and may be even reverse the body and spirit changes.
Latest scientific studies will help you in this journey. Until recently, doctors were not able to perform reliable tests to determine testosterone levels in men. Now, with capable tests and a generation of baby boomers desperate to fight aging, andropause finally looks like it will get its long overdue attention.
Sources and Additional Information: