Is the male menopause real?
The condition appears in some literature as "andropause". However, this label is misleading and the definition of the symptoms, causes, and treatments is still unclear.
According to an article in the journal Social History of Medicine, the male menopause, or andropause, was a much-discussed topic from the late 1930s to the mid-1950s, but modern researchers advise that without clear boundaries, andropause is not a useful diagnosis.
However, aging still produces effects within the male body, including testosterone levels that regularly reduce.
In this article, we examine the effects of aging on hormones in men and steps that can be taken to reduce the impact of aging on men's health.
Is "male menopause" real?
Men experience a range of physical changes when aging, but they do not qualify as a form of menopause.
While advancing in age does have effects on the levels of sex-specific hormones in men, relating the process to female menopause is not accurate.
Some researchers instead associate the symptoms with a condition called androgen decline in the aging male (ADAM), or late-onset hypogonadism. This occurs naturally when the gonads, or organs that produce sex cells, begin to age and lose function.
The condition affects only 2.1 percent of males, while menopause is a natural part of female sexual development. This prevalence increases with age but is still not a standard step in male development.
A doctor will suggest a diagnosis of late-onset hypogonadism when a man demonstrates three sexual symptoms and has androgen levels lower than 11 nanomoles per liter (nmol).
The symptoms of conditions that people often label as male menopause emerge more slowly and subtly and less severely than in menopause.
The decrease in the levels of male hormone, or testosterone, is less severe than the drop in hormone levels for women throughout menopause.
The varied signs and symptoms some people attribute to male menopause include:
- hot flashes
- moodiness and irritability
- fat build-up around the abdomen and the chest
- loss of muscle mass
- dry, thin skin
- excessive sweating
A study in the New England Journal of Medicine (NEJM) identifies the most common symptoms of male menopause as decreased libido, a lower frequency of morning erections, and erectile dysfunction.
The study lists other symptoms that include a loss of energy, an inability to walk more than 1 kilometer, or 0.62 miles, and difficulties completing strenuous physical tasks, such as running or lifting heavy objects.
Kneeling, bending, and stooping might also become more difficult.
After a man reaches the age of 30 years, testosterone levels gradually decrease, falling an average of one percent each year.
However, doctors do not believe that the normal, age-related decline of testosterone levels is at the center of male menopause symptoms. Were this related to the symptoms, every man would experience them, which is not the case.
A lack of exercise can lead to decreasing testosterone in older men.
This condition is complex and can produce different symptoms in different people. While these symptoms often occur in older men with declining testosterone levels, they tend to occur in older males with heart disease, obesity, high blood pressure, and type 2 diabetes.
This suggests that changing levels of male hormones are not the sole contributor to this condition.
Other risk factors include underlying health problems, such as:
Erectile dysfunction may be the result of changes in the blood vessels or a nerve problem.
Some men experience the psychological impact of a "mid-life crisis," in which they become concerned about professional and personal milestones. This can be a cause of depression, which can trigger a range of factors leading to the physical symptoms of ADAM.
A lack of sleep, poor diet and lack of exercise, smoking and alcohol consumption, and low self-esteem may also contribute.
Hypogonadism is a condition in which the testes do not produce enough hormones. In younger males, this can lead to delayed puberty. If it develops at an older age, possibly linked to obesity or type 2 diabetes, the symptoms of ADAM may occur.
One study describes how the male menopause became medicalized, not as a result of scientific research but "a model perpetuated by lay people and medical popularizers."
A physician is not likely to diagnose male menopause. It represents a set of symptoms on which there is little agreement.
These symptoms may occur due to a range of lifestyle factors or underlying diseases.
Since the condition has no clear definition, men who experience these physical changes will receive treatment according to their symptoms.
A person with obesity will receive support for weight management and an exercise regimen. They might also have to adjust their food intake and engage with a well-balanced and nutritious diet.
Careful dietary management can reduce the effects of aging in men.
People with diabetes and cardiovascular disease will require appropriate management for the underlying condition. Controlling blood glucose levels appears to reduce symptoms.
The doctors will carry out a detailed check-up on discovered symptoms such as erectile dysfunction and fatigue to detect any cardiovascular disease, including blood tests and scans.
They may refer an individual with signs of depression or anxiety to a psychologist or psychiatrist, who can prescribe antidepressants, psychotherapy, or both.
A doctor may recommend testosterone therapy but the effectiveness of this treatment is not clear. Testosterone therapy might increase the risks of a blockage in the urinary tract and prostate cancer. It may also aggravate ischemic heart disease, epilepsy, and sleep apnea.
The FDA ruled in 2015 that many testosterone and vitamin supplements claiming to support male menopause often do not contain the advised components and may increase the risk of developing prostate cancer and cardiovascular issues.
Speak to a doctor about managing the symptoms of aging and age-related disease.
Insufficient evidence is available to define "male menopause" as a diagnosable medical condition.
However, ADAM is a deficiency of testosterone, a male sex hormone, that can have similar effects to "male menopause". Conditions involving low testosterone levels can be complicated and show differently for different people.
Doctors do not diagnose male menopause.
However, a lifestyle involving a balanced diet, regular exercise, and minimal tobacco and alcohol use is likely to boost a sense of wellbeing and reduce the physical symptoms of aging in men.
Treating underlying conditions can also reduce the effects.
Is there a diet that can reduce sexual problems in older men?
A varied and balanced diet replete with micronutrients, vitamins, and healthy sources of protein and fat is essential for preventing muscle loss and maintaining good cardiovascular health.
Keeping a healthy weight and preventing complications, such as vascular disease and diabetes, are key in continuing to enjoy all areas of life, including sexual health, as men grow older.